| Objective:Analyze the two-dimensional ultrasound images and ultrasound contrast images of focal liver lesions of children hospitalized in Chongqing Medical University from July 2019 to January 2020,and explore the application value of Contrast-enhanced Ultrasound in children's liver focal lesions.To explore the value of ultrasonography in the diagnosis and differential diagnosis of hepatoblastoma,which is the most common liver malignant embryonic tumor in children,in order to lay the foundation for ultrasound contrast diagnosis of focal liver lesions in children,especially hepatoblastoma.Methods:A total of 26 cases of focal liver lesions hospitalized in the Children's Hospital of Chongqing Medical University from July 2019 to January 2020 were collected.A total of 28 lesions met the inclusion criteria,including 13 cases of hepatoblastoma and 6 cases of liver metastases and 4cases of hepatic hemangioma.It also included one case of focal nodular hyperplasia of the liver,heterogeneous fatty liver,liver abscess,hepatocellular carcinoma,and liver neuroblastoma..Among them,15 cases were confirmed by pathological examination,and 13 cases were auxiliary confirmed by imaging examination and laboratory examination.Observe the two-dimensional ultrasound and Contrast-enhanced Ultrasound images of these children,analyze the characteristics of Contrast-enhanced Ultrasound perfusion and the enhancement level of different phases,and analyze the time intensity curve of the region of interest of ultrasound contrast lesions with the software of the ultrasound instrument.The results of measurement data that conform to the normal distribution are expressed as mean ± standard deviation,and the results of measurement data that do not conform to the normal distribution are expressed as median and interquartile range.Single factor analysis of variance was used to test the measurement data between multiple groups,and t test was used to analyze the difference between the two groups.The count data is expressed as(n,%)with count data,and the chi-square test is used for differences between groups.Statistical inference takes ? = 0.05 as the inspection standard.Results:(1)Comparison of general data of the three groups of patients with hepatoblastoma,liver metastases,and hemangiomas showed that the gender and age distribution of the three groups of patients was relatively uniform,and the difference was not statistically significant(P> 0.05).The distribution of alpha-fetoprotein in laboratory tests was different,and the difference was statistically significant(P <0.05).(2)The characteristics ofthe two-dimensional ultrasound images of the three groups of patients include tumor echo,calcification,liquefaction necrosis and tumor size distribution,and the difference is statistically significant(P <0.05).(3)The ultrasound contrast results of the three groups of patients showed no significant difference in arterial phase enhancement level(P> 0.05),and there were differences in the combination of portal phase and delayed phase enhancement levels and the combination of three time phase enhancement levels,and the difference was statistically significant(P<0.05).(4)The results of quantitative parameters of ultrasound contrast in the three groups showed no statistical significance(P> 0.05).(5)Ultrasound contrast image features of hepatoblastoma include uneven enhancement of arterial phase clusters,and the clearance time is less than60 seconds,which can clearly show the blood supply vessels from the hepatic artery and the small blood vessels and microperfusion inside the tumor that cannot be displayed by two-dimensional ultrasound The area can clearly show the liquefied necrosis area in the tumor,and the display range of liquefied necrosis is more obvious than that of two-dimensional ultrasound;the hepatic hemangioma can show annular enhancement,uniform enhancement and uneven nodular enhancement in the arterial phase,and most of No clearing;the arterial phase of liver metastases showed an overall uniform enhancement,and no large blood vessels were shown.The delayed phase was mainly without enhancement,and it showedobvious "black hole" signs.(6)The incidence of mild adverse reactions of ultrasound contrast agent was 2.53%,and no moderate or severe adverse reactions occurred.Conclusions:(1)Two-dimensional ultrasound image features including echo,calcification,liquefaction necrosis,tumor size and laboratory examination of alpha-fetoprotein are helpful for diagnosis and differentiation of hepatoblastoma,liver metastasis and hemangiomas.(2)The enhanced levels of portal phase and delayed phase of ultrasound contrast and the enhanced levels of arterial phase,portal phase and delayed phase are helpful to distinguish hepatoblastoma,liver metastasis and hemangiomas.(3)In this study,due to the small number of patients in the three groups and the uneven distribution of the number of patients,the quantitative parameter results of the time-intensity curve of ultrasound contrast have no significant differential diagnosis significance in the three groups of diseases.(4)Ultrasound contrast image of hepatoblastoma is superior to two-dimensional ultrasound in showing blood supply vessels,microvessel circulation and liquefaction necrosis area,which is more helpful for the diagnosis of its nature than two-dimensional ultrasound.(5)Hepatic blastoma,hepatic metastasis,and hepatic hemangioma have different characteristics of contrast-enhanced ultrasound images,which have a certain value in differential diagnosis.(6)The application of ultrasound contrast in children's liver diseases has a certain safety effect. |
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