Quantitative Analysis And Study On Focal Liver Lesions By Contrast-Enhanced Ultrasound

Objective: To observe the characteristics of focal liver lesions by using contrast-enhanced ultrasound(CEUS), to investigate the clinical value of quantified parameters of CEUS in evaluating the perfusion of liver lesions. To evaluate the relationship between quantified parameters of CEUS and microvessel density(MVD), the expression of vascular endothelial growth factor(VEGF) in hepatocellular carcinoma(HCC).Methods: In this study,102 patients with hepatic lesions (45 HCCs,12 metastatic liver tumors and 45 benign lesions) were examined with contrast-tuned imaging under a low mechanical index. The perfusion pattern in the arterial phase and quantified parameters were obtained, and the time-intensity curves(TIC) of 102 patients with hepatic lesions were analyzed statistically. MVD and the expression of VEGF in HCC were assessed immunohistochemically. The relationship between quantified parameters of CEUS and MVD, VEGF in 45 HCCs were contrastively analysed.Results:(1)The perfusion pattern of different hepatic lesions in the arterial phase were different. 75.6% of HCC showed holistic hyper-enhancing and 41.7% of metastatic liver cancer(MLC) showed rim hyper-enhancing patterns; 90% of hepatic hemangioma showed peripheral and centripetal enhancement; 55.6% of focal nodular hyperplasia(FNH) showed spoke-wheel and centrifugal enhancement; 88.9% of regenerating nodule and 100% of focal fatty inhomogeneous infiltration showed iso-enhancing. (2)The shapes of the TIC of hepatic benign and malignant lesions were diverse.The curves were slick, low and flat in the benign group,while with sharp angles in the malignant group. Ultrasonographic quantified parameters,such as the peak of the signal intensity and the areas under the curve(AUC) in the malignant group were higher than those in the benign group (P<0.05),whereas there were no significant differences between the time-to-peak(TP) and the sharpness of the curve(Sharpness) in two groups (P>0.05). (3)The MVD was divided into high and low group by the median of 20, peak intensity(Peak) showed significant difference (P<0.01) between the two groups of CEUS parameters in TIC.There were low positive correlation between Peak and MVD (r=0.464,P<0.01), but MVD showed no correlation with TP,Sharpness and AUC(P>0.05); There were no obvious rank correlation between the TIC parameters and the expression of VEGF in 45 HCC(P>0.05), but which showed significant positive correlation (r=0.621,P<0.001) with MVD.Conclusions: Hepactic benign and malignant lesions showed different perfusion enhancing pattern of CEUS; The quantitative parameter Peak of CEUS correlated with MVD in HCC; The expression of VEGF showed positive correlation with MVD,which may indirectly affect the CEUS performance.The quantitative analysis of TIC is valuable for the differential diagnosis of malignant and benign lesions;CEUS could primarily evaluate tumor vascularization activity so that it may provide more reliable basis for further clinical treatment.