The value of a combined use of color Doppler ultrasound blood flow parameters and contrast-enhanced ultrasound in differentiating benign and malignant hepatic focal lesions

Abstract

Abstract: Objective To investigate the value of combining color Doppler ultrasonography (CDUS) blood flow parameters with contrast-enhanced ultrasonography (CEUS) parameters in differentiating benign from malignant hepatic focal lesions. Methods A total of 126 patients with histopathologically confirmed hepatic focal lesions admitted to our hospital from January 2022 to January 2025 were selected. The patients were divided into a benign group and a malignant group based on their pathological findings. All patients underwent both CDUS and CEUS examinations. Blood flow parameters and CEUS parameters were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for malignant lesions, and the diagnostic efficacy of combining CDUS with CEUS in differentiating benign from malignant lesions was evaluated using receiver operating characteristic (ROC) curves. Results In this study, among 126 patients with focal liver lesions, malignant lesions accounted for 54.76% (69/126). In the malignant group, the resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), perfusion index in contrast-enhanced ultrasound (PI-CEUS), and enhancement slope (ES) were 0.88±0.30, 1.70±0.41, (21.09±3.60) cm/s, (28.70±3.26) dB, and 1.82±0.57 respectively, all of which were significantly higher than those in the benign group. The time to peak (TTP) and enhancement time (ET) in the malignant group were (26.22±3.09) seconds and (19.61±2.80) seconds respectively, which were significantly lower than those in the benign group (all P<0.05). Logistic regression analysis showed that increased RI, PSV, and ES were independent risk factors for malignant lesions (OR>1, P<0.05), while increased TTP and ET were independent protective factors (OR<1, P<0.05). Receiver operating characteristic (ROC) curve analysis indicated that the sensitivity, specificity, and area under the curve (AUC) of combined conventional Doppler ultrasound (CDUS) and contrast-enhanced ultrasound (CEUS) for differentiating benign and malignant lesions were 91.3%, 98.2%, and 0.974, respectively. Conclusion Combining CDUS blood flow parameters with CEUS perfusion parameters can effectively differentiate benign from malignant hepatic focal lesions, thus providing a reliable basis for clinical diagnosis.

Key words: Hepatic focal lesions, Benign and malignant, Color doppler ultrasound, Contrast-enhanced ultrasound, Diagnostic efficacy

Chen Xianyan, Zhou Jing, Deng Jiaqi, Tan Chunmei, Yu Xianmei, Du Jian. The value of a combined use of color Doppler ultrasound blood flow parameters and contrast-enhanced ultrasound in differentiating benign and malignant hepatic focal lesions[J]. Chinese Hepatolgy, 2026, 31(7): 980-983.

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