Value Of Three-dimensional Contrast-enhanced Ultrasonography In The Differential Diagnosis Of Benign And Malignant Focal Liver Lesions

ObjectiveTo investigate the imaging methods of three-dimensional contrast-enhancedultrasonography (3D-CEUS) and the imaging3D-CEUS characteristics of benign andmalignant focal liver lesions,and to evaluate the clinical practical value of3D-CEUS inthe diagnosis of benign and malignant focal liver lesions.MethodsWe performed the examinations with transducer C5-2and volume transducer V6-2of Philips iU22ultrasound scanner.Totally,135patients with146focal liver lesionsreferred between July2011and December2012were examined bythree-dimension contrast-enhanced ultrasonography(3D-CEUS) and two-dimensionalcontrast-enhanced ultrasonography (2D-CEUS). QLAB was used to perform thereconstruction of3D-CEUS with all the records stored.Comparing the performance ofCEUS, the image quality, the vascular characteristics of benign and malignant focalliver lesions (including number of nourishing blood vessels, distribution, direction,definition and spatial relationships of blood vessel) and the blood perfusioncharacteristics within the lesions. The results were statistically analyzed with P<0.05indicating significant differences.Results1. The3D-CEUS enhancement patterns of benign and malignant focal liver lesionswere similar to2D-CEUS,there was no significant difference between two imagingmethods (P<0.05). But3D-CEUS can reflect the vascular characteristics of benign andmalignant focal liver lesions and and the blood perfusion characteristics within thelesions from space structure.2.3D-CEUS gave a clear intuitional and stereoscopic view of the vascularcharacteristics of tumors(including number of nourishing blood vessels, distribution,direction, definition and spatial relationships of blood vessel) and the blood perfusion characteristics within the lesions,3D-CEUS was superior to2D-CEUS in the display ofthe vascular characteristics and the blood perfusion characteristics of tumors. Livermalignant lesions mostly displayed winding peripheral vessels and disordered internalvessels with3D-CEUS, the blood perfusion of liver malignant lesions was wholeperfusion,3D-CEUS presented a solid shape. While liver benign tumors mostlydisplayed regular peripheral and internal vessels with3D-CEUS, and no bloodperfusion within the lesions,3D-CEUS presented a hollow shape. Hepatic Hemangiomashowed a hollow shape within the lesion, FNH showed a central star shape, hepaticabscess showed a hollow in areas of liquefy and necrosis in vomica.3. There was no significant difference between the value of3D-CEUS and2D-CEUS in differential diagnosis of focal liver lesions(P<0.05):thesensitivity,specicicity,positive predictive value, negative predictive value and theaccuracy were97.14%,92.86%,97.12%,92.86%and95.89%for3D-CEUS，and were96.15%,90.48%,96.15%,95.00%and94.52%for2D-CEUS. The statistical datas of3D-CEUS were higher than2D-CEUS.Conclusions1. Vascular characteristics of focal liver lesions and the blood perfusioncharacteristics within the lesions are the important parameters of3D-CEUS to identifybenign and malignancy lesions.The3D-CEUS characteristics of benign and malignantfocal liver lesions can more reflect physiopathologic changes of lesions.2.3D-CEUS is a useful technique in the differential diagnosis of focal liver lesionsas well as2D-CEUS, and the statistical datas of3D-CEUS were higher than2D-CEUS.3The3D-CEUS of benign and malignant focal liver lesions can get completeinformations, and3D-CEUS is objectivity, reduced dependent on experience,conducive to the standardization of contrast ultrasonic operation,,further promote thedevelopment of CEUS technique, has good clinical application value.