The Study Of Contrast-enhanced Ultrasound Blood Perfusion And Angiogenesis To Inflammatory Pseudoneoplasm Of The Liver In Fatty Liver And Normal Liver

Objective:By comparing and analysing Inflammatory Pseudoneoplasm of liver (IPL)with fatty liver and nomal liver perfusion blood characteristics and Contrast-enhanced ultrasound quantitative parameters, and the correlation between the quantitative parameters and angiogenesis.To inquire into ability of CEUS in diagnosing IPL in different hepatic background and assessing angiogenesis.Methods:Modelling IPLwith fatty liver and nomal liver. By low mechanical index real-time ultrasound with bolus injection of SonoVue via peripheral auricular vein and QontraXt quantitative analysis software, analysing perfusion blood characteristics and the quantitative parameters. Combining immunohistochemical and Real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) to test microvessel density(MVD)、vascular endothelial growth factor (VEGF) and VEGF-mRNA, to inquire into the correlation between the quantitative parameters and angiogenesis.Resluts:(1) The perfusion blood characteristics of Contrast-enhanced ultrasound and the comparation of quantitative parameters:①According to the different pathological results, IPL showed four kinds of CEUS types:one lesion showed absent contrast enhancement pattern (type Ⅰ); nineteen lesions showed iso-enhancement pattern (type Ⅱ); six lesions showed hypor-enhancement pattern (type Ⅲ); thirteen lesions showed fast-in and fast-out pattern (type IV).②Compared with normal liver, the beginning of time of fatty liver was later and its peak intensity was lower.③Compared with peripheral parenchymal, The beginning of time of IPL was later, peak intensity was lower and its sharpness was sharper (P<0.05).④Comparison of the IPL with two different liver background, there was no significant difference of parameters of the time-intensity curve (P>0.05).(2) Comparation of VEGF-mRNA between IPL and liver around the lisions:①Compared with normal liver,2-ΔCTof fatty liver was lower(P=0.011).②Compared with the lisions in normal liver,2-ΔCT of the lisions in fatty liver was lower(P=0.016).Explaining VEGF-mRNA is lower in fatty liver then normal liver, VEGF-mRNA is lower in the lisions in fatty liver then the lisions in normal liver.(3) Comparation of VEGF and MVD between IPL and liver around the lisions:①VEGF internal and surrounding lisions with fatty liver is2.60±1.09and2.95±1.00; VEGF internal and surrounding lisions with normal liver is3.16±0.69and3.21±0.71.②MVD in lisions with fatty liver is21.10±3.31; MVD in lisions with normal liver is22.37±3.27.③VEGF surrounding lisions correlate with MVD.(4) The relevance between perfusion blood characteristics and MVD、VEGF:①The VEGF-mRNA is relevant to peak intensity in normal liver、fatty liver and lisions with normal liver (r=0.538, P=0.018; r=0.488, P=0.029; r=0.655,P=0.002);②VEGF protein expression is relevant to peak intensity and sharpness in lisions with normal liver and fatty liver(r=0.554,P=0.014; r=0.633, P=0.003),(r=-0.459, P=0.048; r=-0.641, P=0.002).③MVD is relevant to peak intensity and sharpness in lisions with normal liver and fatty liver (r=0.681, P=0.001; r=0.828, P=0.000),(r=-0.497, P=0.030; r=-0.655,P=0.002).Conclusions:(1) Due to different pathological elements, IPL lesions have multiform perfusion patterns in CEUS. CEUS and time intensity curve could provide enough perfusion information for IPL and liver parenchyma more accurately.(2) CEUS blood perfusion in fatty liver was lower than that in normal liver. The expression of VEGF gene in fatty livers were lower than those in normal livers.(3) Peak intensity is relevant to MVD、VEGF-mRNA and VEGF protein expression, so it can reflect angiogenesis indirectly.CEUS can be as a non-invasive, fast and convenient imaging method to reflect angiogenesis of tissue.