Clinical application of contrast-enhanced ultrasonography for malignant hepatic lesions undetected on conventional ultrasound / 中华超声影像学杂志

ABSTRACT

Objective To explore the value of contrast-enhanced ultrasound(CEUS) on the diagnosis of undetected liver cancer.Methods The study was focused on 85 consecutive patients from Jan 2015 to Sep 2016.The patients suspected liver cancer by clinical symptoms and other imaging studies were examined for regular gray-scale ultrasound and CEUS.Results Ninety-two lesions in 85 patients were confirmed by surgery,clinic manifestation and other imaging.All lesions including invisible or poorly invisible with greyscale ultrasound were examined by CEUS with the guideline of MRI imaging.Twenty lesions were detected by grey-scale ultrasound,89 lesions were detected by CEUS.The maximum diameter of those hepatic lesions was 20 mm × 18 mm,the minimum lesions was 8 mm × 6 mm.All the lesions were isoechoic,slightly hyperechoic or hypoechoic on grey-scale sonogram with mostly indistinctive margins.After SonoVue administration,82 lesions (92.1 ％) displayed as hyper-enhanced in arterial phase and 7 lesions (7.9 ％) as iso-enhanced.Sixty-one lesions(68.5 ％) showed hypo-enhanced and 28 lesions (31.5 ％) showed iso-enhanced in portal-vein phase.Seventy-four lesions(83.1 ％) showed hypo-enhancement and 15 lesions (16.9 ％) also showed iso-enhanced in late phase.The average enhancement time began at (15.3 ±6.1)s,reached to peak at (25.2 ± 8.8)s and decreased from (95.7 ± 57.8)s.Among 89 lesions,61 lesions (68.5％) were accordanced with fast in fast out and 28 lesions (31.5％) were no fast in fast out.The percentage of no fast in fast out on CEUS in undetected liver tumor was higher than in common liver tumor,the comparative difference was statistically significant (P ＜ 0.01).Conclusions Contrast-enhanced ultrasound has a more characteristic performance in undetected liver cancer and the higher detection rate than grey scale ultrasound.