Study Of Ultrasound Imaging Of Focal Liver Lesions

PartⅠDiagnostic Value of Focal Liver Lesions by Contrast-enhanced Ultrasound:Compare with Contrast-enhanced CTPurposeTo investigate the diagnostic value of Contrast-enhanced ultrasound(CEUS) and compare the diagnostic value and features of CEUS with Contrast-enhanced CT(CECT).Material and methodsFrom Dec 2004 to May 2007,81 focal liver lesions(FLLs) were evaluated with CEUS and CECT,diagnostic value of two modalities were calculated and compared,and the value of CEUS enhancement pattern were investigated in focal nodular hyperplasia,haemangioma and metastases.ResultsThe diagnostic value of CEUS and CECT are similar,CEUS could show more hypervascular metastases in arterial phase than CECT(P＜0.05). Centrifugal enhancement pattern should not be regarded as a specific feature of focal nodular hyperplasia;sensitivity,specificity,PPV,NPV and accuracy of centripetal enhancement for the diagnosis of haemangioma were 87.5%,100%,100%,98.7%,98.8%respectively.Sensitivity, specificity,PPV,NPV and accuracy of circular enhancement for the diagnosis of metastases were 80%,98.2%,95.2%,91.7%and 92.6% respectively.ConclusionsThe diagnostic value of CEUS and CECT in FLLs are satisfying,and there is no difference between them.Centrifugal enhancement pattern should not be regarded as a specific manifestation of focal nodular hyperplasia; centripetal enhancement and circular enhancement were highly suggestive of liver haemangioma and liver metastases respectively. PartⅡComparison of Wash-out Time of Hepatocelluar Carcinoma on Contrast-enhanced Ultrasonography with Pathological Result of Anti-CD34 Histoimmunological StainPurposeTo investigate the relationship between wash-out time and MVC,and investigate the relationship between wash-out time and MVD area proportion.Material and methodsFrom Dec 2004 to Apr 2007,a total of 329 focal liver lesions with 31 hepatolcellular carcinomas which were confirmed by operation result were prospectively evaluated with contrast-enhanced ultrasonography, wash-in and wash-out time,peak time were recorded,take advantage of CD34 histoimmunological stain in the resected specimen to do MVC and calculate MVD area proportion;investigate relationship between wash-out time and MVC,wash-out time and MVD area proportion.ResultsWash-time and MVD area proportion are positively correlated(r=0.45); there are no relationship between wash-out time and MFC(r=-.007).ConclusionWash out time and MVD area proportion are positively correlated; there are no relationship between wash-time and MVC. PartⅢPrimary study of influence factors on contrast-enhanced ultrasonography in patients with focal liver lesionsPurposeTo analyze factors that could affect contrast-enhanced ultrasonography procedure of focal liver lesion,and try to investigate methods to solve the problems.Material and methodsFrom Nov 2004 to May 2007,totally,there were 11 CEUS that could not be accomplished successfully by one procedure,4 patients are male,and 7 patients are female.Age ranged:48 to 71,mean age:52±10.1,middle age:61.Patients without final diagnosis and intact CEUS data were excluded.Contraindication of CEUS:history of coronary heart disease, allergy tendency and people less than 18 years old.In 2 situations listed below,if one thing happened,the procedure defined as unsuccessful procedure:①could not locate the lesion without aids of ultrasound contrast.②enhancement pattern could not be appreciated completely or the location of the lesion could not be appreciated in portal phase and late phase.Once the CEUS finished,the procedures were evaluated instantly,try to analyze the reasons of failed cases,and then try to improve imaging methods and try the CEUS again.Results2 lesions that could not be located by conventional US are relocated with the help of ultrasound contrast.5 tough CEUS for operator reason were tried again by adjusting access direction or just repeating the procedure,4 of 5 failed cases(4/5,80%) were accomplished.4 tough CEUS for the reason of unsuccessful breath cooperation were tried again,by adjusting access direction or by using contrast/side by side preset,2 of them(2/4,50%) were accomplished.ConclusionsCEUS could help to locate the lesion which could not be detected by conventional US;Adjusting the access direction,repeating CEUS and using contrast/side by side preset may be helpful for the tough cases。...