The Diagnostic Value Of Quantitative Analysis With Contrast-Enhanced Ultrasound In Recurrent Small Hepatocellular Carcinoma

BackgroundPrimary carcinoma of the liver is one of common malignant tumor in our country. Hepatocellular carcinoma accounts for more than 90% of primary carcinoma of the liver. The malignant of hepatocellular carcinoma is high, easy to spread in the liver,distant metastasis, relapse after resection, and is not sensitive to radiotherapy and systemic chemotherapy. In the early stage, the symptoms of hepatocellular carcinoma are not typical, so are often to be missed diagnosis. however, is developing rapidly, when to be discovered, is the late stage of the tumor. Therefore, detected small hepatocellular carcinoma in the early stage is particularly important. Researches about imaging of small hepatocellular carcinoma are mainly based on contrast-enhanced Computed tomography, magnetic resonance imaging. However, there are few studies about contrast-enhanced ultrasound in the diagnosis of recurrent small hepatocellular carcinoma is rare deals. In this study, quantitative analysis of contrast-enhanced ultrasound were performed on patients with recurrent small hepatocellular carcinoma to investigate the practical value of quantitative analysis of contrast-enhanced ultrasound. ObjectiveTo compare the efficacy quantitative analysis of contrast-enhanced ultrasound with co ntrast-enhanced computed tomography in characterization of recurrent small hepatocellular carcinoma. MethodsQuantitative analysis of contrast-enhanced ultrasound and contrast-enhanced Computed tomography were performed on 151 patients with recurrent small hepatocellular carcinoma, and the diagnoses were made before operation or biopsy. The diagnostic performance was calculated by considering histologic results as the reference standards. Results1.in arterial phase, the number of the lesions with hyper-enhancing on quantitative analysis of contrast-enhanced ultrasound and contrast-enhanced Computed tomography was 138( 91.4%) and 135(89.4%), respectively(P=0.121);in portal phase, the number of the lesions with hypo-enhancing on quantitative analysis of contrast-enhanced ultrasound and contrast-enhanced Computed tomography was 59(39.1%) and 57( 37.8%), respectively(P=0.877);in delayed phase, the number of the lesions with hypo-enhancing on quantitative analysis of contrast-enhanced ultrasound and contrast-enhanced Computed tomography was 139(92.1%) and 136(90%), respectively(P=0.845).2.Four cases were overlooked by quantitative analysis of contrast-enhanced ultrasound and 6 cases were missed by contrast-enhanced Computed tomography. Ten cases( including 5 cholangiocarcinomas,1 liver metastasis,1 hemangiomas,1 adenomas,3 regenerative nodules,1 focal nodular hyperplasias)were misdiagnosed by quantitative analysis of contrast-enhanced ultrasound and 14 cases( including 2 cholangiocarcinomas,3 liver metastasis,2 hemangiomas,1 adenomas,4 regenerative nodules,2 focal nodular hyperplasias) were misdiagnosed by contrast-enhanced Computed tomography.The detection rate of recurrent small hepatocellular carcinoma was 97.4% for quantitative analysis of contrast-enhanced ultrasound and 96% for contrast-enhanced Computed tomography(P=0.195);The overall accuracy was 93.4% for quantitative analysis of contrast-enhanced ultrasound and 90.7% for contrast-enhanced Computed tomography(P=0.073).3.The parameters of RT,TTP,MTT, time from peak to 1/2 in the tumor were significantly different from those in liver parenchyma(P=0.007,P=0.000,P=0.000, P=0.000). The parameter of AUC in the tumor was no significantly different from those in liver parenchyma(P=0.543). ConclusionsThe quantitative analysis of contrast-enhanced ultrasound is at least comparable with contrast-enhanced Computed tomography in detection and characterization of recurrent small hepatocellular carcinoma and has high diagnostic performance independent contrast-enhanced Computed tomography.