Clinical application of intra-hepatic arterial contrast enhanced ultrasound for evaluation of draining area characteristics of hepatocellular carcinoma

doi:10.3877/cma.j.issn.1672-6448.2021.01.009

Abstract

Abstract:

Objective

To evaluate the clinical value of intra-hepatic arterial contrast-enhanced ultrasound (IHA-CEUS) in evaluating the draining area of hepatocellular carcinoma (HCC) by comparing with peripheral venous contrast-enhanced ultrasound (PV-CEUS).

Methods

A total of 54 lesions were selected from 44 patients admitted to the interventional radiology department of PLA General Hospital and treated by transhepatic arterial chemotherapy and embolization (TACE) from August 2018 to February 2019. Preoperative grey-scale ultrasound and PV-CEUS were performed on the patients, tumor location, tumor number, maximum diameter, internal echo, and blood perfusion information of the target lesions were recorded, and the characteristics of the corona hyperenhancement and its thickness in the draining area were analyzed. Before TACE treatment, HA-CEUS was performed after a microcatheter was inserted into the hepatic artery. The tumors were divided into groups according to their maximum diameter:≤3 cm, >3 cm but≤5 cm, and>5 cm; the visualization rate and the thickness of the corona hyperenhancement of the draining area by PV-CEUS and HA-CEUS were compared. The correlation between the maximum diameter of the tumor and the thickness of the corona hyperenhancement was evaluated by linear correlation analysis.

Results

For all lesions and lesions ≤3 cm, >3 cm but ≤5 cm, and >5 cm in the maximum diameter, both the visualization rate and the thickness of tumor drainaging area by IHA-CEUS were significantly higher than those by PV-CEUS [visualization rate: 83.3% vs 22.2%, χ²=31.030, P<0.001; 78.1% vs 15.6%, χ²=17.053, P<0.001; 90.9% vs 36.4%, χ²=4.167, P=0.031; and 90.9% vs 27.3%, χ²=5.143, P=0.016; thickness: (0.58±0.44) cm vs (0.14±0.23) cm, t=7.680, P<0.001; (0.41±0.27) cm vs (0.09±0.19) cm, t=6.238, P<0.001; (0.83±0.50) cm vs (0.29±0.27) cm, t=3.845, P=0.009; and (0.89±0.58) cm vs (0.17±0.28) cm, t=4.289, P=0.002]. There was a positive linear correlation between the maximum diameter of the tumor and corona enhancement thickness. The regression equation of the thickness of the corona enhancement in IHA-CEUS and the diameter of the tumor was Y=0.0805X+ 0.4464 (F=19.171, R²=0.269, P<0.001).

Conclusion

Compared with PV-CEUS, HA-CEUS is more effective in displaying the draining area of HCC lesions.

Key words: Carcinoma, hepatocellular, Draining area, Intra-hepatic arterial contrast-enhanced ultrasound

Bo Jiang, Xiang Fei, Peng Han, Ying Zhang, Qing Song, Fang Xie, Yukun Luo, Jie Tang. Clinical application of intra-hepatic arterial contrast enhanced ultrasound for evaluation of draining area characteristics of hepatocellular carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(01): 40-44.

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Figures/Tables 4

References 13

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造影方式	总体	≤3 cm	>3 cm且≤5 cm	>5 cm
经肝动脉超声造影	83.3（45/54）	78.1（25/32）	90.9（10/11）	90.9（10/11）
经外周静脉超声造影	22.2（12/54）	15.6（5/32）	36.4（4/11）	27.3（3/11）
χ²值	31.030	17.053	4.167	5.143
P值	<0.001	<0.001	0.031	0.016

造影方式	总体	≤3 cm	>3 cm且≤5 cm	>5 cm
经肝动脉超声造影	83.3（45/54）	78.1（25/32）	90.9（10/11）	90.9（10/11）
经外周静脉超声造影	22.2（12/54）	15.6（5/32）	36.4（4/11）	27.3（3/11）
χ²值	31.030	17.053	4.167	5.143
P值	<0.001	<0.001	0.031	0.016

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