The Diagnostic Evaluation Of Contrast-Enhanced Ultrasound,Contrast-Enhanced CT,Contrast-enhanced MRI In Middle,small Liver Lesions With Negetive Aplha-fetoprotein

Objective:To evaluate the diagnostic efficacy of contrast-enhanced ultrasonography,contrast-enhanced CT,contrast-enhanced MRI in middle, small focal liver lesions with negative aplha-fetoprotein.Methods:To analyze125cases of AFP-negative liver imaging diagnosis of middle,small focal liver lesions with pathological diagnosis, the case inclusion criteria:(1) newly discovered liver lesions;②lesion diameter≤5cm, single;③serum AFP<200ng/ml;④at least two kinds or more imaging studies;⑤the final histopathologic diagnosis.The cases of preoperative diagnosis of hepatic hemangiomas and liver cyst, or pathology confirmed metastatic tumors, were excluded from the study cohort. All125patients underwent routine ultrasound examination,95patients with CEUS examination,106patients with CECT examination,54patients with CEMRI examination.To analyze CEUS, CECT CEMRI imaging diagnosis and pathological diagnosis,to calculate of the various imaging diagnostic efficacy such as accuracy, specificity, sensitivity, positive predictive value, negative predictive value. Result:The accuracy of CEUS,CECT,CEMRI diagnosis of middle,small focal liver lesions lesions with negative aplha-fetoprotein were88.3%,81.5%,69.8%, specificity were71.4%,38.1%,25.0%respectively, sensitivity were95.4%,94.4%,87.1%respectively.positive predictive values were88.5%,83.8%,75.0%respectively, negative predictive values were86.9%,66.7%,42.9%respectively.; diagnostic accuracy of CEUS, CECT and CEMRI malignant liver lesions were94.9%,85.9%,74.2%respectively., the diagnostic accuracy of CEUS, CECT and CEMRI liver hyperplasia were65.0%,6.7%,0respectively; the diagnostic accuracy of CEUS+CECT connection was96.1%. the diagnostic accuracy of the diameter≤3.0cm negative AFP liver space occupying lesions with CEUS, CECT CEMRI were90.0%,77.3%,71.4%respectively, the specificity were76.2%,31.3%,20.0%respectively; the diagnostic accuracy of AFP≤20ng/ml liver space lesions with CEUS, CECT CEMRI were85.2%,82.8%63.3%respectively, and specificity were72.0%,44.4%,25.0%respectively; the diagnostic accuracy of HBsAg(-) liver space lesions with CEUS, CECT CEMRI were were96.3%,76.7%,66.7%, and specificity were92.3%,45.5%,42.9%; of CEUS, CECT CEMRI respectively, the diagnostic accuracy of cirrhotic liver liver space lesions with CEUS, CECT CEMRI were86.1%,71.9%,50.0%respectively. CEUS has lower cost, reduce the burden on the patients.Conclusion:The diagnostic accuracy of CEUS and CECT have no differences in in middle-. small focal liver lesions with negative aplha-fetoprotein, the both diagnostic accuracy was higher than higher than CEMRI; the correct rate of CEUS in middle,small benign focal liver lesions with negative aplha-fetoprotein was higher than the CECT and CEMRI; imaging combination can improve the diagnosis of liver lesions accuracy rate; ultrasound contrast has a simple and rapid operation, real-time dynamic,safe,relatively inexpensive price advantage, it is worth of promoting in clinic.