Preliminary study on hepatic perfusion disorders in small focal liver lesions with contrast-enhanced ultrusonography during arterial phase / 中华超声影像学杂志

ABSTRACT

Objective To investigate the imaging characteristics and differentiating value of hepatic perfusion disorders(HPD)in small focal liver lesions(≤3 cm),the transient hepatic hyperechoic enhancement(THHE),with contrast-enhanced ultrasonography(CEUS)during arterial phase and explore the potential mechanism.Methods Two hundred and sixty-eight small foeal liver lesions found in 215 patients who had undergone CEUS were retrospectively evaluated in this study.Hepatic parenchymal THHEs around those lesions were diagnosed and the CEUS characteristics as well as the detecting rate related to different lesions were analyzed.Results Forty-five among 268 lesions(16.8%)showed surrounding THHEs during CEUS and they exhibited fast wash-in to form hyperechoic area of different shape and range and then those area became fast washout to be isoechoic in contrast with peripheral liver parenchyma.According to the imaging morphology,THHEs could be divided into four typestype Ⅰ,wedge-or fan-shaped(51.1%);type Ⅱ,encircling-shaped(20.0%);type Ⅲ,nodule-like-shaped(11.1%);type Ⅳ,irregular-shaped(17.8%).According to the pathology,the liver focal lesions could be divided into three groupsbenign group,which consisted of 88 lesions and 8(9.1%)lesions showed surrounding THHEs of which 87.5% presented type Ⅲ and Ⅳ;malignant group,which consisted of 141 lesions and 31(22.0%)lesions showed surrounding THHEs of which 67.7% presented type Ⅰ;tumor-like lesions group,which consisted of 39 lesions and 6(15.4%)lesions showed surrounding THHEs of which 66.7% presented type Ⅱ.There was significant difference in the composition of THHEs type among three groups(P＜0.001).The detecting rate of THHEs in benign group was lower than that in other groups(P＜0.05).Conclusions THHEs showed with CEUS in small liver focal lesions are representation of HPD and have different detecting rate and imaging morphology type in different lesions.It is very important to recognize and distinguish THHEs surrounding focal lesions,which could help to make differential diagnosis,avoid incorrect diagnosis and judge the size of lesions correctly.