wei yang, Presenter: Nothing to Disclose

Kun Yan MA, Abstract Co-Author: Nothing to Disclose

Wei Wu PhD, Abstract Co-Author: Nothing to Disclose

Ying Dai MD, Abstract Co-Author: Nothing to Disclose

Minhua Chen, Abstract Co-Author: Nothing to Disclose

To investigate the role of enhancement patterns and time intensity curve (TIC) of contrast enhanced ultrasound (CEUS) in differential diagnosis of atypical hepatic inflammatory lesions and hepatocellular carcinoma (HCC).

37 consecutive cases of inflammatory liver lesions were suspected as malignancy by conventional US and underwent CEUS examination in our department. Of them, 23 cases with atypical perfusion pattern (enhancement in arterial phase) which mimic HCC feature were included in the study (inflammatory group). At the same period, 385 patients with HCC were also underwent CEUS. HCC group is comparatively large, thus 46 HCC patients were randomly selected to be the control group (HCC group). Each lesion was scanned with low-MI CEUS with SonoVue as the contrast agent. CEUS enhancement features and TIC parameters of the liver lesions were evaluated and compared.  A stepwise logistic regression model was carried out using the CEUS findings as independent variables to determine the significant factors for differentiate inflammatory lesion from HCC.

Logistic regression analysis showed three significant factors in differential diagnosis for inflammatory lesions and HCC, including feeding vessel (P= 0.003), lesion margin at enhancing peak (P=0.005) and shape of internal necrotic area (P=0.015). Combined these three factors, the diagnosis sensitivity, specificity and accuracy were 91.3%, 93.5% and 92.7%, respectively. Quantitative analysis of TIC showed statistic significance between HCC and inflammatory lesions in lesion/parenchymal peak intensity/time difference, lesion accelerate time, curve ascending slope and area under curve, suggesting inflammatory lesions showed less-intense enhancement with took longer time to reach enhancing peak

Analysis of CEUS pattern and TIC provides important information for differentiating atypical inflammatory liver lesions and HCC, and is helpful for improves diagnostic accuracy and decrease unnecessary invasive diagnostic method.

the diagnosis sensitivity, specificity and accuracy for atypical inflammatory liver lesions with CEUS were 91.3%, 93.5% and 92.7%.

yang, w, Yan, K, Wu, W, Dai, Y, Chen, M, The Role of Contrast Enhanced Ultrasound in Differential Diagnosis between Atypical Hepatic Inflammatory Lesions and Hepatocellular Carcinoma.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043480.html