Correlation Between The Quantitative Parameter Of Contrast-enhanced Ultrasonography, CT Perfusion Eighted Imaging And MRI Perfusion Weighted Imaging In VX2Hepatocellular Carcinoma

Introduction：1. Compared with conventional ultrasound and contrast-enhancedultrasound, to explore its assessment of the value in the diagnosis ofhepatocellular carcinoma.2. Summary analysis of the correlation between the CEUS quantitativeparameters and biochemical indicators of MVD and VEGF, to find the clinicalvalue of it; and then investigate the relative between it and CT and MRIperfusion weighted imaging quantitative indicators.Material and method:Twenty-five New-Zealand white rabbits were inoculated with VX2carcinoma in the liver by laparotomy implantation, the conventional colorultrasound and the CEUS which injection Sonovue by ear marginal vein wereperformed14days after molding respectively and imagines were then makinga comparative study of the two-dimensional and blood supply.The CEUS examinations were performed on25VX2HepatocellularCarcinoma rabbit model and analyzed the dynamic images by QLAB. Andthen get the parameters ascending slope (AS), arrival time (AT), time-to-peak(TTP), peak intensity (PI), area under curve (AUC) and relativeparameters(the discrepancy of HCC and tissue around it). perform CT andMRI Perfusion Weighted Imaging，get the parameters blood flow(BF), blood volume(BV), permeability surface(PS), mean transit time (MTT) of CT, andmean time to enhance(MTE), positive enhancement integral(PEI), time topeak(TP) and maximum slope of increase(MSI) of MRI，sacrificed them anddetected MVD and VEGF.Results:1. Among the24cases of25Lesions, conventional ultrasound detected22lesions, size0.92±0.15cm,5of which showed clear boundaries, theothers were not; Color Doppler detected different levels of blood flow signalsin16nodules, while CEUS detected25lesions, size1.13±0.24cm, All ofthem had clearly boundaries and10had necrotic areas. Among thequantitative parameter of CEUS, AT, TTP, PI showed significant different(P<0.01) between Hepatocellular Carcinoma and the Surrounding normalliver tissue. Among the Hepatocellular Carcinoma quantitative parameters ofCEUS, the relative time to peak was positive correlated to MVD andVEGF(r=0.517,0.528, P<0.05), the relative peak intensity was positivecorrelated to MVD(r=0.564, P<0.01). There was also correlation betweenVEGF and MVD(r=0.641, P=0.01).2. Among the quantitative parameter of CEUS, relative time to peak waspositive correlated to BF（r=0.557, P=0.028）, Negative correlation to TP（r=-0.424, P=0.035）, the relative peak intensity was positive correlated toBF and PEI（r=0.393,0.484，P=0.012,0.024）。Conclusion:CEUS could provide the perfusion of early liver lesions, displaying theinternal necrotic areas, infiltrating invasion and internal blood supply moresensitively. To some extent, Contrast-enhanced ultrasound quantitativeparameters have some clinical practical value; reflect tumor micro vascular distribution inside, as well as CT Perfusion Weighted Imaging and MRIPerfusion Weighted Imaging.