Contrast-enhanced ultrasound perfusion characteristics of different nodules in hepatitis B-related cirrhosis

Abstract

Abstract: Objective To analyze the features of different nodules in hepatitis B-related cirrhosis during the contrast-enhanced ultrasound perfusion (CEUS) phase and assess the diagnostic value of CEUS phase analysis technology for these nodules. Methods Pathological examination identified 128 hyperplastic nodules, 16 atypical hyperplastic nodules, and 39 minimal hepatocellular carcinoma (HCC) out of 193 nodules. Ultrasound contrast examination showed 120 hyperplastic nodules, 25 atypical hyperplastic nodules, and 38 minimal HCC out of 183 nodules. Results Three phase enhanced scanning of hyperplastic nodules are mainly manifested as isoechoic-isoechoic-isoechoic enhancement. Atypical hyperplastic nodules mainly exhibited hyperechoic or hypoechoic-isoechoic-isoechoic enhancement. Small HCC is mainly manifested as hyperechoic-isoechoic or hypoechoic enhancement, with these contrast-enhanced ultrasound features being statistically significant (P<0.05). The RBF (regional blood flow) in the three-phase enhanced scanning of hyperplastic nodules were (38.95 ± 13.73) mL/s, (104.82 ± 31.59) mL/s, and (42.93 ± 11.39) mL/s, respectively. The RBV (regional blood flow) were (1281.46 ± 422.08) mL, (1347.25 ± 416.98) mL, and (729.61 ± 218.36) mL, respectively. For atypical hyperplastic nodules, the RBF values were (42.92 ± 12.36) mL/s, (27.26 ± 6.52) mL/s, and (25.17 ± 7.36) mL/s, with RBV values of (1498.63 ± 472.56) mL, (1984.63 ± 315.09) mL, and (603.94 ± 96.83) mL, respectively. For small HCC, the RBF values were (63.19 ± 10.58) mL/s, (28.33 ± 5.96) mL/s, and (18.24 ± 5.13) mL/s, respectively, with RBV values of (3385.26 ± 517.94) mL, (1205.94 ± 256.37) mL, and (372.19 ± 74.35) mL, respectively, showing statistical significance (P<0.05). Pathological examination showed 128 hyperplastic nodules, 16 atypical hyperplastic nodules, and 39 minimal HCC out of 193 nodules. Ultrasound contrast-enhanced examination showed 120 hyperplastic nodules, 25 atypical hyperplastic nodules, and 38 minimal HCC out of 183 nodules. The sensitivity, specificity, accuracy, and Kappa value of contrast-enhanced ultrasound for diagnosing hyperplastic nodules were 0.922, 0.964, 0.934, and 0.850, respectively. For diagnosing atypical hyperplastic nodules, the sensitivity was 0.750, specificity was 0.922, accuracy was 0.907, and the Kappa value was 0.536. For diagnosing small hepatocellular carcinoma, the sensitivity was 0.846, specificity was 0.965, accuracy was 0.940, and the Kappa value was 0.819. Conclusion The analysis of the CEUS shows different enhancement modes for hyperplastic nodules, atypical hyperplastic nodules, and micro HCC in the context of hepatitis B-related cirrhosis. The RBF and RBV values also vary across different perfusion phases. CEUS demonstrates significant value in diagnosing nodules of different natures and and in the early detection of micro HCC.

Key words: Hepatitis B-related cirrhosis, Hypertrophic nodules, Atypical hyperplastic nodules, Small hepatocellular carcinoma, Contrast-enhanced ultrasound

FU Peng, TANG Ya-dan, YANG Fang-fang, YANG Li-xin. Contrast-enhanced ultrasound perfusion characteristics of different nodules in hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2024, 29(7): 813-816.

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