Analysis on the value of contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma with portal vein thrombosis

Abstract

Abstract: Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in hepatocellular carcinoma (HCC) patients with portal vein thrombosis (PVT). Methods Fifty-two HCC patients combined with PVT (35 males and 17 females) admitted to our hospital from January 2015 to September 2020 were retrospected, with an average age of (59.5 ± 8.6) years old. Thirty-eight were malignant PVT (malignant PVT group), including 32 males and 6 females, 14 were benign PVT (benign PVT group), including 9 males and 5 females. Measurement data were analyzed by t-test or Kruskal-Wallis H test; counting data were analyzed by chi-square test. Results The ages of malignant PVT group and benign PVT group were 58.0 ± 9.2 years and 63.1 ± 5.2 years, respectively, with statistical significance (t=4.104, P<0.05). The AFP levels of the 2 groups were 176.4 (13.8, 2150.4) ng/dl and 4.8 (2.2, 146.8) ng/dl, respectively, with statistical significance (Z=-40.146, P<0.05). The diameters of HCC lesions of the 2 groups were (8.8 ± 4.6) cm and (5.2 ± 4.7) cm, with statistical significance (t=-12.745, P<0.05). However, there was no significant difference in Child-Pugh score, number and location of HCC lesions between the two groups (P>0.05). The times to peak of the 2 groups were (48.3 ± 25.8) s and (80.6 ± 52.4) s, with statistical significance (t=17.540, P<0.05). The peak intensities of the 2 groups were (17.4 ± 5.0) dB and (12.5 ± 5.1) dB, with statistical significance (t=-11.745, P<0.05). The area under the curve (AUC) of the 2 groups were (2130.8 ± 721.6) dB/s and (1114.3 ± 816.7) dB/s, with statistical significance (t=-18.005, P<0.05). The rising times of the 2 groups were (16.6 ± 8.4) s and (8.6 ± 6.4) s, with statistical significance (t=-21.126, P < 0.05). The enhancement on arterial phase of the 2 groups were 36 cases (94.7%) and 8 cases (19.5%), with statistical significance (χ²=-11.107, P<0.05). The wash-out on delay phase of the 2 groups were 32 cases (84.2%) and 1 case (7.1%), with statistical significance (χ²=-26.205, P<0.05). The sensitivity, specificity and accuracy of CEUS in diagnosing malignant PVT were 89.5% (34/38), 100% (14/14) and 92.3% (48/52), respectively. Conclusion CEUS performs well in the differential diagnosis of PVT in HCC patients, which is worth promoting clinically.

Key words: Hepatocellular carcinoma, Contrast-enhanced ultrasound, Portal vein thrombosis

LIU Jia, HAO Li-jun, JIANG Wei, WANG Zhen-qi. Analysis on the value of contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma with portal vein thrombosis[J]. Chinese Hepatolgy, 2021, 26(10): 1099-1102.

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