Value Of Contrast-enhanced Ultrasound Quantitative Analysis In The Diagnosis Of Benign And Malignant Lesions Of Common Bile Duct

Objectives: To investigate the value of contrast-enhanced ultrasound combined with time-intensity curve,quantitative analysis of peak time,area under curve and gradient in differential diagnosis of benign and malignant lesions of lower common bile duct.Methods:78 patients with abdominal pain,abdominal distension and jaundice were admitted to the Department of Hepatobiliary Surgery of Hunan People’s Hospital from January 2017 to March 2018.They were diagnosed as lower common bile duct lesions.The patients were examined by conventional ultrasound and contrast-enhanced ultrasound,and the mode of contrast-enhanced ultrasound was observed and recorded.Combined with TIC analysis,three groups of contrast-enhanced parameters were obtained: peak time,area under curve and gradient.Pathological results of 78 patients were followed up,61 of them had pathological results.According to pathological types,the patients were divided into benign group and malignant group,of which 28 were benign group and 33 were malignant group.At the same time,25 normal volunteers were enrolled as normal control group(Patients without lower common bile duct lesions).The same three groups of contrast-enhanced ultrasound parameters were obtained.Result:1.After the injection of contrast medium,the boundary and size of the lesions in the lower part of the common bile duct were clearer.2.In malignant group,there were 26 cases with high enhancement in arterial phase,24 cases with low enhancement in venous phase and 2 cases with equal enhancement in arterial phase;4 cases with equal enhancement in arterial phase,2 cases with low enhancement in venous phase and 2 cases with equal enhancement in venous phase;and 3 cases with low enhancement in arterial phase and venous phase.3.In benign group,there were 5 cases of high enhancement in arterial phase,1 case of low enhancement in venous phase,4 cases of equal enhancement and 23 cases of equal enhancement in arterial phase,19 cases of equal enhancement in venous phase and 4 cases of low enhancement.4.There was no significant difference in TTP,AUC and Grad between the benign group and the peripheral normal bile duct wall(P > 0.05).5.There were significant differences in TTP,AUC and Grad between the lower common bile duct lesions in malignant group and the normal bile duct wall around them(P < 0.05).6.There were significant differences in contrast-enhanced ultrasound parameters TTP,AUC and Grad between benign and malignant lesions of lower common bile duct(P < 0.05).7.In the three groups,there was no significant difference in TTP,AUC and Grad in the parameters of contrast-enhanced ultrasonography of the lower common bile duct wall(P > 0.05).Conclusion:1.Contrast-enhanced ultrasound can make the boundary and size of the lower common bile duct lesions clearer.2.Contrast-enhanced ultrasound perfusion pattern and enhancement degree of benign and malignant lesions in lower common bile duct are different.3.Differences in time-intensity curve parameters between benign and malignant lesions of lower common bile duct.The peak time of malignant lesions was shorter than that of benign lesions,while the area and gradient under the curve of malignant lesions were larger than that of benign lesions.To provide a basis for further study of this difference in the diagnosis of benign and malignant lesions of the lower common bile duct.