Value of contrast-enhanced ultrasonography in differential diagnosis of hepatic space-occupying lesions in high-risk patients with hepatocellular carcinoma
Objective To assess the efficacy of contrast-enhanced ultrasonography in differentiating hepatic space-occupying lesions in high-risk patients with hepatocellular carcinoma.Methods A retrospective analysis was conducted on the imaging data from 160 high-risk patients diagnosed with hepatocellular carcinoma who had presented with space-occupying lesions(204 lesions)between September 2018 and June 2022.All patients underwent contrast-enhanced ultrasonography,with pathological examination being utilized as the gold standard.The consistency between contrast-enhanced ultrasonography finding and pathological results was assessed.Additionally,the arrival time,the peak time,the washout time were compared between benign and malignant liver lesions.Results A total of 204 liver space-occupying lesions were identified in the study cohort,,of which 158 malignant lesions(93 hepatocellular carcinoma lesions,56 metastatic hepatocellular carcinoma,and 9 cholangiocarcinoma)and 46 benign lesions(34 hepatic hemangioma,7 cirrhotic nodular lesions and 5 hepatic focal nodular hyperplasia lesions).Malignant lesions demonstrated earlier arrival time,shorter peak time,and earlier washout time compared to benign lesions(P＜0.05).Among the 204 hepatic focal lesions,contrast-enhanced ultrasound diagnosed 151 malignant lesions and 37 benign lesions,aligning well with the pathological diagnoses and demonstrating good agreement(Kappa=0.772,P＜0.05).ROC analysis indicated that the sensitivity,specificity and Youden index of contrast-enhanced ultrasonography in diagnosing malignant liver space-occupying lesions in high-risk patients with hepatocellu lar carcinoma were 95.57％(151/158),80.43％(37/46),and 0.760,respectively.Conclusion CEUS emerges as a valuable modality for distinguishing between hepatic space-occupying lesions in high-risk patients with hepatocellular carcinoma.
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