Abstract:
Objective To compare the ultrasonographic characteristics of hepatic neuroendocrine neoplasms (HNENs) and hepatocellular carcinoma (HCC), and to explore the value of ultrasound in the differential diagnosis of the two entities.
Methods Ultrasonographic characteristics of 40 patients who were confirmed pathologically as having HNENs at Zhongshan Hospital, Fudan University from September 2009 to December 2020 were analyzed retrospectively. Forty patients confirmed pathologically as having HCC in the same period were chosen as a control group. The number of lesions, boundary, echogenicity, and the detection rate of artery Doppler signal were observed by conventional ultrasonography, and the enhancement time, enhancement pattern, imaging features at peak time, manifestations of lesions in the portal vein phase and delayed phase were observed by contrast enhanced ultrasonography (CEUS). The differences in enhancement start time, peak time, and regression time were compared by the independent sample t-test or Mann-Whitney U test, while the differences in the number of lesions, boundary, echo level, and detection rate of arterial blood flow signal between the two groups were compared using the χ2 test or the exact probabilistic test.
Results There were statistically significant differences in the number of lesions, regression time, enhancement pattern, imaging features at peak time, and manifestations in the portal vein phase and delayed phase between HNENs and HCC (P＜0.05). Compared with HCC, HNENs were more likely to be multiple nodules (27/40 vs 5/40, Z=4.592, P＜0.001). On CEUS, the regression time of enhancement was earlier in HNENs than in HCC [40.0 (33.0, 49.3) s vs 67.0 (48.8, 120.0) s; P＜0.001]. HNENs more often showed centripetal enhancement, rim-like enhancement at peak time, and remarkable hypo-enhancement in the portal phase and delayed phase than HCC (8/40 vs 0/40, P=0.005; 5/40 vs 0/40, P=0.048; 29/40 vs 9/40, P<0.001; 36/40 vs 22/40, P=0.002).
Conclusion Ultrasonographic characteristics of HNEHs are different from those of HCC, and CEUS is useful for the differential diagnosis of HNENs and HCC.
Key words:
Ultrasonography,
Contrast enhanced ultrasonography,
Hepatocellular carcinoma,
Hepatic neuroendocrine neoplasms
Hantao Wang, Weibin Zhang, Peili Fan, Yi Dong, Qing Lu, Zheng Zhu, Wenping Wang. Comparative analysis of ultrasonographic characteristics between hepatic neuroendocrine neoplasms and hepatocellular carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(01): 70-77.