Optimization of imaging diagnosis for hepatic lesions less than 2 cm

doi:10.3877/cma.j.issn.1674-0793.2017.01.006

Abstract

Abstract:

Objective

To evaluate the value of diagnosis for less than 2 cm liver lesions using contrast-enhanced ultrasound, contrast-enhanced computed tomography, enhanced perfusion imaging and diffusion imaging.

Methods

Fifty-three patients with nodules less than 2 cm underwent standardized contrast-enhanced ultrasound, CT, and MRI scans, respectively. Final diagnosis was determined by pathology or follow-up. Comparative analysis of its diagnostic sensitivity, specificity and accuracy was performed retrospectively.

Results

Based on the pathology or follow-up for patients, we confirmed that there were 27 patients of primary liver cancer, 10 focal nodular hyperplasia, 9 hemangioma, 4 metastatic tumor, 2 liver angioleiomyolipoma, and 1 liver cyst coincidence with infection. Combined with the three diagnosis tests, we found that enhanced perfusion imaging and diffusion imaging had a higher sensitivity, specifity and accuracy (91%, 97%, 93%, respectively) than contrast-enhanced ultrasound, and was significantly prior to computed tomography (P<0.05).

Conclusion

MR enhanced perfusion imaging and diffusion imaging and contrast-enhanced ultrasound has an excellent diagnostic value for liver tumors <2 cm.

Key words: Ultrasonography, Tomography, spiral computed, Perfusion imaging, Magnetic resonance imaging, Liver neoplasms

Jian Wang, Wanguang Zhang. Optimization of imaging diagnosis for hepatic lesions less than 2 cm[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(01): 23-27.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2017.01.006

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2017/V11/I01/23

Figures/Tables 4

References 10

[1]	Youk JH,Kim CS,Lee JM. Contrast-enhanced agent detection imaging: value in the characterization of focal hepatic lesions[J]. J Ultrasound Med, 2003, 22(9): 897-910.
[2]	Liu JJ,Li HX,Chen ZB, et al. Consistency analysis of contrast-enhanced ultrasound and contrast-enhanced CT in diagnosis of small hepatocellular carcinoma[J]. Int J Clin Exp Med, 2015, 8(11): 21466-21471.
[3]	Choi SH,Byun JH,Lim YS, et al. Diagnostic criteria for hepatocellular carcinoma <3 cm with hepatocyte-specific contrast-enhanced magnetic resonance imaging[J]. J Hepatol, 2016, 64(5): 1099-1107.
[4]	徐辉雄,吕明德,谢晓燕. 超声造影对肝脏肿瘤定性诊断的研究[J]. 中国实用外科杂志, 2004, 24(11): 669-671.
[5]	Lewis S,Dyvorne H,Cui Y, et al. Diffusion-weighted imaging of the liver techniques and applications[J]. Magn Reson Imaging Clin N Am, 2014, 22(3): 373-395.
[6]	卞读军,胡冬煦,肖恩华. 肝脏磁共振扩散加权成像技术及其研究进展[J]. 放射学实践, 2007, 22(11): 1232-1235.
[7]	董利刚,胡春艾,夏平. 肝脏肿瘤多层螺旋CT与MRI影像学特点及鉴别价值比较[J]. 中国CT和MRI杂志, 2015, 13(12): 60-61.
[8]	Ichikawa T,Saito K,Yoshioka N, et al. Detection and characterization of focal liver lesions: a Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease[J]. Invest Radiol, 2009, 45(3): 133-141.
[9]	Kwon H,Byun JH,Kim JY, et al. Differentiation of small (≤2 cm) hepatocellular carcinomas from small benign nodules in cirrhotic liver on gadoxetic acid-enhanced and diffusion-weighted magnetic resonance images[J]. Abdom Imaging, 2015, 40(1): 64-75.
[10]	Khalili K,Kim TK,Jang HJ, et al. Optimization of imaging diagnosis of 1-2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization[J]. J Hepatol, 2011, 54(4): 723-728.

检查项目	TP	FN	FP	TN	敏感度		特异度		PPV（%）	准确性		NPV（%）
检查项目	TP	FN	FP	TN	%	P值	%	P值	PPV（%）	%	P值	NPV（%）
增强CT	26	10	3	25	72	0.147^a	89	0.639^a	89	71	80	0.144^a
超声造影	31	5	2	26	86	0.466^b	93	0.553^b	94	84	89	0.344^b
PWI+DWI	33	3	1	27	91	0.032^c	97	0.299^c	97	90	93	0.019^c

检查项目	TP	FN	FP	TN	敏感度		特异度		PPV（%）	准确性		NPV（%）
检查项目	TP	FN	FP	TN	%	P值	%	P值	PPV（%）	%	P值	NPV（%）
增强CT	26	10	3	25	72	0.147^a	89	0.639^a	89	71	80	0.144^a
超声造影	31	5	2	26	86	0.466^b	93	0.553^b	94	84	89	0.344^b
PWI+DWI	33	3	1	27	91	0.032^c	97	0.299^c	97	90	93	0.019^c

[1]	Jianquan Zhang, Jie Cheng, Hongqiong Chen, Lei Yan. Evaluation of ablated thyroid areas using ACR-TIRADS：a survey study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(10): 966-971.
[2]	Hui Luo, Ye Fang. Application of quality control circles in improving detection rate of thyroid nodules by fine-needle aspiration [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(10): 972-977.
[3]	Zhong Yang, Jingye Shi, Xuedong Deng, Wei Jiang, Linliang Yin, Qi Pan, Hong Liang, Jianfang Ma, Zhenqi Wang, Jun Zhang, Shanshan Dong. Diagnostic value of prenatal ultrasound in fetal 22q11.2 microdeletion syndrome [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 852-858.
[4]	Yanjuan Bao, Xiaohong Yang, Tao Zhang, Sheng Zhao, Li Zhang. Ultrasound diagnosis and clinical analysis of obstructed hemivagina and ipsilateral renal anomaly syndrome [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 859-864.
[5]	Sirui Liu, Chenyang Zhao, Rui Zhang, Yixiu Zhang, Meng Yang. Comprehensive evaluation of hemodynamic parameters at different segments of the uterine artery in pregnant rats using Doppler ultrasonography [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 877-883.
[6]	Jiali Sun, Lin Jin, Cuiqin Shen, Qingqing Chen, Yanping Lin, Zhaojun Li, Dong Xu. Ultrasound-guided robot-assisted percutaneous puncture： an experimental study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 884-889.
[7]	Xuebing Shi, Yingdong Xie, Ni Xie, Chaoli Xu, Bin Yang, Guo Sun. Acoustic radiation force imaging for evaluating efficacy of radiotherapy in unresectable hepatocellular carcinoma patients with portal vein tumor thrombus [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 778-784.
[8]	Junying Gao, Haizhou Zhang, Hongle Qu, Qiang Sun. Progress in the application of FOLFOX-HAIC-based adjuvant translational therapy for hepatocellular carcinoma [J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(06): 457-463.
[9]	Xiaowei Chang, Yu Cai, Zhiyong Zhao, Wei Zhang. Efficacy and safety analysis of high intensity focused ultrasound ablation combined with hepatic arterial chemoembolization in the treatment of primary hepatocellular carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 56-59.
[10]	Daiqin Li, Peijie Liu. Value of dynamic enhanced magnetic resonance imaging in evaluating the efficacy and prognosis of middle and advanced low rectal cancer after concurrent chemoradiotherapy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 100-103.
[11]	Quanyou Lai, Yuan Gao, Jianlin Wang, Shibin Qu, Dan Wei, Wei Peng. Effects of 3D reconstruction technology combined with laparoscopic precision hepatectomy on the levels of CD4+, CD8+ and immunoglobulin in patients with liver cancer after surgery [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 651-654.
[12]	Yifan Li, Diwen Zhu, Weixin Ren, Yingjun Bao, Junpeng Gu, Haixiao Zhang, Gengfei Cao, Weizheng Ji. Role of serum GP73 level in the evaluation of TACE efficacy for primary liver cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 825-830.
[13]	Jingming Lu, Dawei Han, Yaoxing Ren, Tianxiao Huang, Junxi Xiang, Xufeng Zhang, Yi Lyu, Fumin Wang. Meta-analysis of lymph node metastasis prediction of intrahepatic cholangiocarcinoma based on preoperative radiomics [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 852-858.
[14]	Xueyun Wu, Xiaojun Hu, Yingfang Fan. Evaluation and prediction of residual liver regeneration ability for hepatectomy [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 894-897.
[15]	Jingming Wang, Lei Wang, Xiaoduo Xu, Wenqiang Xing, Zhaoyan Zhang, Weimin Huang. Advances in research of paravertebral muscles of the lumbar spine [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(09): 846-852.

Please choose a citation manager

Content to export