Value of Sonazoid contrast-enhanced ultrasound for preoperatively evaluating pathological grade of hepatocellular carcinoma

doi:10.11958/20231409

Abstract

Abstract:

Objective To analyze the correlation between the characteristics of Sonazoid contrast-enhanced ultrasound (CEUS) and pathological differentiation in hepatocellular carcinoma (HCC). Methods A total of 64 patients with HCC diagnosed pathologically by CEUS examination were included, and a total of 64 lesions were divided into the high, medium and low differentiation groups (6, 48 and 10 cases, respectively) according to the degree of pathological differentiation. The enhancement pattern, enhancement level and enhancement pattern of CEUS arterial stage in HCC with different pathological differentiation were compared. Results The enhancement pattern of arterial phase was divided into the uniform enhancement and the uneven enhancement. All lesions in the low differentiated group and 58.3% in the middle differentiated group showed uneven and high enhancement. In the highly differentiated group, lesions showed homogenous hyperintensification, homogenous isointensification and non-homogenous hyperintensification. At arterial stage, all lesions in the middle and low differentiated groups and 66.7% lesions in the highly differentiated group showed high enhancement, and the enhancement levels of HCC with different differentiation degrees were significantly different (P<0.01). At the portal stage, 16.7%, 25.0% and 70.0% lesions in the high, medium and low differentiated HCC groups subsided to low enhancement, and the enhancement levels of HCC with different differentiation degrees were significantly different (P<0.05). In the delayed stage, 75% lesions in the medium-differentiated group and all lesions in the low-differentiated group showed low enhancement, and 66.7% lesions in the highly differentiated group showed equal enhancement. Enhancement levels of HCC with different differentiation degrees were significantly different (P<0.01). At the Kupffer stage, all lesions in the low differentiated group and 95.8% of the moderately differentiated group showed low enhancement, while 50% lesions in the highly differentiated group still showed equal enhancement, and there were significant differences in the enhancement levels of HCC with different differentiation degrees (P<0.01). The highly differentiated group showed multiple CEUS patterns, the moderately differentiated group mainly showed "fast advance and fast retreat" and "fast advance and slow retreat" patterns, and 90.0% of the low differentiated group showed "fast advance and fast retreat" patterns. There were significant differences in CEUS patterns between HCC with different degrees of differentiation (P<0.01). Conclusion Sonazoid-CEUS has certain value in evaluating the differentiation degree of HCC.

Key words: liver neoplasms, pathology, contrast media, Sonazoid, contrast-enhanced ultrasound

CLC Number:

R735.7

Figures/Tables 5

References 19

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组别	n	动脉期			门脉期			延迟期			Kupffer期
组别	n	高增强	等增强	低增强	高增强	等增强	低增强	高增强	等增强	低增强	高增强	等增强	低增强
高分化组	6	4（66.7）	2（33.3）	0	0	5（83.3）	1（16.7）	0	4（66.7）	2（33.3）	0	3（50.0）	3（50.0）
中分化组	48	48（100.0）	0	0	1（2.1）	35（72.9）	12（25.0）	0	12（25.0）	36（75.0）	0	2（4.2）	46（95.8）
低分化组	10	10（100.0）	0	0	0	3（30.0）	7（70.0）	0	0	10（100.0）	0	0	10（100.0）
P		0.007^▲			0.046^▲			0.008^▲			0.006^▲

组别	n	动脉期			门脉期			延迟期			Kupffer期
组别	n	高增强	等增强	低增强	高增强	等增强	低增强	高增强	等增强	低增强	高增强	等增强	低增强
高分化组	6	4（66.7）	2（33.3）	0	0	5（83.3）	1（16.7）	0	4（66.7）	2（33.3）	0	3（50.0）	3（50.0）
中分化组	48	48（100.0）	0	0	1（2.1）	35（72.9）	12（25.0）	0	12（25.0）	36（75.0）	0	2（4.2）	46（95.8）
低分化组	10	10（100.0）	0	0	0	3（30.0）	7（70.0）	0	0	10（100.0）	0	0	10（100.0）
P		0.007^▲			0.046^▲			0.008^▲			0.006^▲

组别	n	快进快退	快进慢退	快进同退	同进同退	快进同退并Kupffer 期消退
高分化组	6	1（16.7）	1（16.7）	1（16.7）	2（33.3）	1（16.7）
中分化组	48	21（43.8）	15（31.2）	2（4.2）	0	10（20.8）
低分化组	10	9（90.0）	1（10.0）	0	0	0
P		0.004^▲

组别	n	快进快退	快进慢退	快进同退	同进同退	快进同退并Kupffer 期消退
高分化组	6	1（16.7）	1（16.7）	1（16.7）	2（33.3）	1（16.7）
中分化组	48	21（43.8）	15（31.2）	2（4.2）	0	10（20.8）
低分化组	10	9（90.0）	1（10.0）	0	0	0
P		0.004^▲