An analysis on the consistency between arterial phase diagnosis of contrast-enhanced ultrasound and pathological results of micro-hepatocellular carcinoma in the context of liver cirrhosis

Abstract

Abstract: Objective To analysis the significance of the arterial phase contrast-enhanced ultrasound (CEUS) in the diagnosis of micro-hepatocellular carcinoma in the context of liver cirrhosis. Methods 66 patients with liver nodules (totally 70 nodules) were included in the study from August 2016 to August 2021. All patients had background of liver cirrhosis. The nature of the lesions was confirmed by pathological examination, and the patients were divided into micro-liver cancer group (38 cases, 40 nodules) and non-malignant nodule group (28 cases, 30 nodules). Before pathological diagnosis, all patients underwent CEUS examination. The CEUS enhanced perfusion mode, descending branch halving time, enhancement peak time and continuous enhancement time of each lesion were observed, and the consistency between CEUS diagnosis of micro-hepatocellular carcinoma under the background of liver cirrhosis and pathological results was analyzed. Results The arterial phase of all lesions in micro-liver cancer group was high enhancement, and the portal vein phase was mainly low enhancement (32/40, 80.00%); In the non-malignant group, the arterial phase was mainly low enhancement (17/30, 56.67%), and the portal phase was mainly equal enhancement (22/30, 73.33%). The enhancement levels of arterial phase and portal vein phase between the two groups was significantly differenct (P<0.05). The descending branch halving time (84.68±18.20)s, peak enhancement time (22.65±8.84)s and continuous enhancement time (41.03±10.81)s in the micro- hepatocellular carcinoma group were lower than those in the non-malignant group [(115.03 ± 20.12)s, (30.59 ± 10.75)s, (84.54 ± 18.20)s] (P<0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of CEUS were 92.50%, 80.00%, 87.14%, 86.05%, 88.89% and 0.734 respectively. Conclusion The perfusion of minuscule liver nodules in the early stage of hepatocellular carcinoma is different from that of liver cirrhosis. CEUS has important value in the diagnosis of micro-liver cancer complicated with liver cirrhosis.

Key words: Contrast-enhanced ultrasound, Arterial phase, Diagnosis, Cirrhosis, Micro-hepatocellular carcinoma

YIN Wei, FENG Yu-cheng, LUO Song-zhi, DAI Sheng-dao. An analysis on the consistency between arterial phase diagnosis of contrast-enhanced ultrasound and pathological results of micro-hepatocellular carcinoma in the context of liver cirrhosis[J]. Chinese Hepatolgy, 2023, 28(2): 200-202.

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