The Application Of Ultrasonic Multimodal In The Diagnosis Of Hepatic Alveolar Echinococcosis

Objective: To investigate the application value of ultrasonic multimodal in the diagnosis of hepatic alveolar echinococcosis.Methods: We examined 95 cases of liver nodules from the patients who were treated in our hospital during September 2015 and February 2017.These liver nodules were scanned with two-dimensional ultrasonography,color doppler ultrasonography and elastography.Some of liver nodules were scanned with contrast-enhanced ultrasound(CEUS).Record the size of the lesions and elasticity score respectively.Level 5rating method was used for elastic score.The whole CEUS examination was stored as a dynamic digital video files on the hard disk of the US system.Then the video was processed and analyzed,draw the time intensity curve.All of the lesions were classified into three types.Then recorded CEUS quantitative parameters(p I;Tp;AUC;MTT)of the center area,marginal area and normal area surrounding the lesions for each type of HAE lesions.And then compared with surgery or pathologic results,comprehensive evaluation of the clinical application of ultrasonography in diagnosis of HAE.Results: all the cases can be divided into primary hepatic carcinoma,HAE,liver hemangioma and liver cystic hydatid disease four groups.Under the same cross section and elasticity imaging condition,between primary liver cancer and liver echinococcosis group,the area of the lesions,perimeter and volume were significantly greater than that of the conventional ultrasonic conditions(t= 3.164,2.292,2.359,4.388,2.442,4.559;P= 0.005,0.033,0.029,0.000,0.018,0.000).Elasticity score of primary hepatic carcinoma lesions is significantly greater than that of hepatic AE(t= 2.640;P= 2.640),Elasticity score of hepatic AE lesions is significantly greater than that of liver hemangioma(t= 9.136,P< 0.001).Of all the hepatic AE lesions,in the contrast between the nonenhanced internal areas,the marginal areas and normal regions around the lesions,we can get the imaging parameters p I and AUC has significant difference(P< 0.01);On the marginal areas of the different types of hepatic AE lesions,p I,Tp,and MTT show a significant difference(F= 8.832,9.088,5.538;P= 0.001,0.001,0.007).By comparison between any two means,p I,Tp,AUC and MTT four parameters,the difference between infiltrating type and liquid type,calcification type and liquid type had statistical significance(P= 0.000,0.007,0.025,0.007;0.000,0.000,0.032,0.002).Infiltrating type and calcification type has no significant difference.In the non-enhanced internal regions and the normal regions around the lesions,p I,Tp,AUC and MTT did not show significant difference(P> 0.05).Conclusion: Elastography is good at to distinguish the hardness of primary hepatic carcinoma,hepatic AE and liver hemangioma.This will play an effective auxiliary function in the diagnosis of hepatic AE.CEUS will be more accurately display the blood supply of marginal areas than conventional ultrasound;In the marginal areas of lesions,there are different characteristics of CEUS parameters in different types of HAE lesions.The blood supply of the marginal areas of infiltrative type and calcification type lesions is richer than that of the liquefaction type.The results of the present study are of great important for further research in this field and this will provide a theoretical support for surgical resection.