Evaluation Of Microvascular Blood Flow Signals In Focal Liver Lesions By Superb Microascular Imaging

ObjectivesTo explore the diagnostic value of superb microvascular imaging in the microvascular blood flow signal of focal liver lesions.Materials and methods55 patients with 59 focal hepatic lesions(FLL)were enrolled in this study from January 2015 to January 2016.Among them,46 lesions were confirmed by pathology while 13 FLLs were diagnosed by contrast-enhanced CT/MRI findings which did not change over within two years.All patients underwent routine ultrasonography(US),color Doppler flow imaging(CDFI)and superb microvascular imaging(SMI).The maximum diameter of the lesion and the SMI manifestation were recorded.Adler semi-quantitative assessment was used to grade the distribution of blood flow signal for each FLL by two observers,then inter-observer agreement was assessed.ResultsThere are 36 hepatocellular carcinoma(HCC),10 metastatic hepatic carcinoma(MHC),7 focal nodular hyperplasia(FNH)and 6 hepatic hemangioma(HH)in 55patients.The diagnostic accuracy rate of FNH by CDFI was 42.80%,and which by SMI was 85.70%(P<0.05).The diagnostic accuracy rates of CDFI and SMI of HCC,MHC and HE were 86.60%,98.06%,74.79%and 88.02%,99.09%,86.61%respectively.There were no significant differences in the results between the two diagnostic methods(P>0.05).The consistency of two observers grading CDFI andSMI blood flow evaluated by Kappa consistency test.The weighted Kappa coefficients of CDFI and SMI were 0.541 and 0.620,respectively.The consistency scores of the two different observers were moderate and high,respectively.Among the 59 lesions,the semi-quantitative grades of the Adler semi-quantitative grades of CDFI and SMI microvascular flow were CDFI 6 cases(10.16%),24 cases(40.68%),and 15 cases(25.42%)and 14 cases(23.73%);SMI 0 case,13 cases(22.03%),12 cases(20.33%),and 34 cases(57.63%).SMI showed significantly higher blood flow signal performance in blood flow of FLLs than CDFI(P<0.05).Of the 46 malignant lesions,30 had a maximum diameter of<30 mm and the remaining 16 lesions had a maximum diameter of>30 mm.SMI can detect the vascular structure of all 46 lesions,while CDFI failed to detect the vascular structure of 6 lesions in the<30mm group.The blood flow rate of SMI for<30mm malignant lesions was significantly higher than CDFI(P<0.05).ConclusionsSMI shows that the ability of microvascular blood flow signals in liver focal lesions is better than CDFI,which can better display much more fine blood vessels,and has certain value in the differential diagnosis of focal liver lesions.Compared with CDFI,SMI has higher accuracy of FLLs and can provide important guidance for clinical treatment and disease diagnosis.