Image quality of dynamic three-dimensional contrast-enhanced ultrasonography in focal liver lesions:an analysis of influencing factors

doi:10.3877/cma.j.issn.1674-0793.2018.02.008

Abstract

Abstract:

Objective

To explore 4D-CEUS methodologies and the factors affecting image quality.

Methods

4D-CEUS data of one hundred and fifty-one focal liver confirmed by pathology and clinical follow-up from the First Affiliated Hospital of Sun Yat-sen University were respectively analyzed. The image quality was scored and influencing factors were analyzed.

Results

(1) The injection methods of 4D-CEUS had significant influence on the imaging quality of 4D-CEUS, while slow injecting contrast agents without saline could prolong pure arterial pulse, mean time was (5.17±1.03) s, with image quality superior to conventional bolus (statistical value 88.868, P=0.000). (2) The image quality of 4D-CEUS in the arterial phase of 151 FLLs was divided into 4 grades, with 82 cases (54.3%) in grade 1, 17 cases (11.3%)in grade 2, 25 cases (16.6%) in grade 3, 27 cases (17.9%) in grade 4. The number of lesions showing hyper-enhancement, iso-enhancement, hypo-enhancement was 119 (78.8%), 6 (4.0%) and 26 (17.2%), respectively. Location of lesions, sizes, scanning path, interference, and the artifacts had significant influences on the image quality of 4D-CEUS (statistical values -2.455, -2.198, -2.428, -5.575, -6.469, 43.060, all P<0.05).

Conclusion

The image quality of 4D-CEUS is affected by the method of injection, sizes of lesions, location, blood supply, scanning path, the presence of artifacts, and the presence of interference.

Key words: Liver diseases, Imaging, three-dimensional, Ultrasonography, Focal liver lesions

Ying Lu, Guangliang Huang, Yanling Zheng, Baoxian Liu, Mianni Chen, Xiaoyan Xie. Image quality of dynamic three-dimensional contrast-enhanced ultrasonography in focal liver lesions:an analysis of influencing factors[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(02): 106-110.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2018.02.008

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2018/V12/I02/106

Figures/Tables 4

References 16

[1]	Wilson SR, Burns PN. An algorithm for the diagnosis of focal liver masses using microbubble contrast-enhanced pulse-inversion sonography[J]. AJR Am J Roentgenol, 2006, 186(5): 1401-1412.
[2]	Luo W, Numata K, Morimoto M, et al. Clinical utility of contrast-enhanced three-dimensional ultrasound imaging with Sonazoid: findings on hepatocellular carcinoma lesions[J]. Eur J Radiol, 2009, 72(3): 425-431.
[3]	Luo W, Numata K, Morimoto M, et al. Three-dimensional contrast-enhanced sonography of vascular patterns of focal liver tumors: pilot study of visualization methods[J]. AJR Am J Roentgenol, 2009, 192(1): 165-173.
[4]	王文平，毛丽娟，丁红, 等. 动态三维超声造影在肝肿瘤诊断中的初步应用[J]. 中华医学超声杂志, 2011, 8(5): 976-983.
[5]	Eisenbrey JR, Sridharan A, Machado P, et al. Three-dimensional subharmonic ultrasound imaging in vitro and in vivo[J]. Acad Radiol, 2012, 19(6): 732-739.
[6]	Claudon M, Dietrich CF, Choi BI, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver-update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS[J]. Ultrasound Med Biol, 2013, 39(2): 187-210.
[7]	刘广健，吕明德. 超声造影在肝脏肿瘤的临床应用[J]. 中国癌症防治杂志, 2012, 4(2): 106-109.
[8]	Ohto M, Ito R, Soma N, et al. Contrast-enhanced 3D ultrasonography in minute hepatocellular carcinoma[J]. J Med Ultrason, 2011, 38(1): 3-12.
[9]	Shi H, Yu XH, Guo XZ. Double contrast-enhanced two-dimensional and threedimensional ultrasonography for evaluation of gastric lesions[J]. World J Gastroenterol, 2012, 18(31): 36-44.
[10]	Luo W, Numata K, Morimoto M, et al. Focal liver tumors: characterization with 3D perflubutane microbubble contrast agent-enhanced US versus 3D contrast-enhanced multidetector CT[J]. Radiology, 2009, 251(1): 287-295.
[11]	Salvatore V, Borghi A, Piscaglia F. Contrast-enhanced ultrasound for liver imaging: recent advances[J]. Curr Pharm Des, 2012, 18(15): 2236-2252.
[12]	Dong FJ, Xu JF, Du D, et al. 3D analysis is superior to 2D analysis for contrast-enhanced ultrasound in revealing vascularity in focal liver lesions—a retrospective analysis of 83 cases[J]. Ultrasonics, 2016, 70: 221-226.
[13]	Brooks D, Lindsey K, Heath Martin, et al. Adaptive windowing in contrast-enhanced intravascular ultrasound imaging[J]. Ultrasonics, 2016, 70: 123-1135.
[14]	尹珊珊，严昆，戴莹, 等. 实时灰阶超声造影对肝硬化定量诊断的初步探讨[J]. 中国医学影像技术, 2004, 20(5): 731-733.
[15]	Xu HX, Lu MD, Xie XH, et al. Three-dimensional contrast-enhanced ultrasound of the liver: experience of 92 cases[J]. Ultrasonics, 2009, 49(3): 377-385.
[16]	董辉，丛文铭. 提高肝癌规范化病理诊断水平，为临床精细化治疗保驾护航—《原发性肝癌规范化病理诊断指南（2015年版）》解读[J]. 中国普通外科杂志, 2016, 25(7): 939-943.

因素		例数	1级	2级	3级	4级	统计值	P值
直径（cm）
	≤3	41	16	6	7	12	-2.455^c	0.014
	>3	110	66	11	18	15	-2.455^c	0.014
病变位置
	肝左叶	27	10	3	6	8	-2.198^c	0.028
	肝右叶	124	72	14	19	19	-2.198^c	0.028
扫查路径
	肋间	102	62	13	11	16	-2.428^c	0.015
	肋下	49	20	4	14	11	-2.428^c	0.015
干扰因素^a
	有	35	3	10	10	12	-5.575^c	<0.001
	无	116	79	7	15	15	-5.575^c	<0.001
伪影^b
	有	50	6	12	18	14	-6.469^c	<0.001
	无	101	76	5	7	13	-6.469^c	<0.001
动脉期增强程度
	高	117	78	15	14	10	43.060^d	<0.001
	等	8	1	1	1	5
	低或无	26	3	1	10	12
合计		151	82	17	25	27

因素		例数	1级	2级	3级	4级	统计值	P值
直径（cm）
	≤3	41	16	6	7	12	-2.455^c	0.014
	>3	110	66	11	18	15	-2.455^c	0.014
病变位置
	肝左叶	27	10	3	6	8	-2.198^c	0.028
	肝右叶	124	72	14	19	19	-2.198^c	0.028
扫查路径
	肋间	102	62	13	11	16	-2.428^c	0.015
	肋下	49	20	4	14	11	-2.428^c	0.015
干扰因素^a
	有	35	3	10	10	12	-5.575^c	<0.001
	无	116	79	7	15	15	-5.575^c	<0.001
伪影^b
	有	50	6	12	18	14	-6.469^c	<0.001
	无	101	76	5	7	13	-6.469^c	<0.001
动脉期增强程度
	高	117	78	15	14	10	43.060^d	<0.001
	等	8	1	1	1	5
	低或无	26	3	1	10	12
合计		151	82	17	25	27

Please choose a citation manager

Content to export