Clinical Study On Quantitative Analysis Of Hepatocellular Carcinoma And Hepatic Hemangioma By Contrast-enhanced Ultrasound Parameter PTM And Acoustic Radiation Force Impulse

Objective:To explore the diagnostic value of contrast enhanced ultrasound imaging parameter PTM(Product of TTP and MTT)and VTQ(virtual touch tissue quantification)of ARFI(acoustic radiation force impulse)in hepatocellular carcinoma(HCC)and hepatic hemangioma.Methods:The contrast enhanced ultrasound and ARFI-VTQ data of 24 HCC cases confirmed by pathology.32 hepatic hemangioma cases confirmed by pathology,enhanced CT and MRI.and 32 cases in control group from October 2016 to December 2019 in our hospital were analyzed retrospectively.measured separately TTP,MTT,VTQ,calculated PTM and performed statistical analysis.constructed ROC curve of HCC and hepatic hemangioma for differential diagnosis of conventional ultrasound and conventional parameters of contrast enhanced ultrasound and PTM and ARFI-VTQ.Calculated the area under the curve and compared them.Results:There were 24 cases of HCC,TTP38.91±7.46s,MTT87.35±26.84s,PTM3452.51±1412.59s2,VTQ2.60(1.91,3.18)m/s;32 lesions of hepatic hemangioma,TTP84.64±23.97s,MTT142.05±27.94s,PTM12430.18±5341.86s2,VTQ1.35(1.22,1.59)m/s;32 normal controls,TTP62.66±11.51s,MTT110.13 ± 16.05s,PTM6981.77±2013.77s2,VTQ1.12(1.00,1.21)m/s,there were significant difference between the groups(P<0.05)(see Table 1,table 2).The area under ROC curve of conventional ultrasound,conventional parameters of contrast enhanced ultrasound,PTM and VTQ for differential diagnosis of HCC and hepatic hemangioma was 0.682,0.865,0.980 and 0.953 respectively.PTM and VTQ were more effective than conventional ultrasound in the differential diagnosis of HCC and hepatic hemangioma(P<0.05).PTM was more effective than conventional parameters of contrast-enhanced ultrasound(P<0.05).There was no significant difference in the area under the curve between PTM and VTQ,betweenVTQ and conventional parameters of contrast enhanced ultrasound.(P>0.05)(see Table 3).Conclusions:Ultrasound contrast parameter PTM and ARFI-VTQ had obvious differential diagnosis on both HCC and hepatic hemangioma,and the diagnostic efficiency was higher than that of conventional ultrasound,they could provide further quantitative analysis methods for identification.Liver contrast-enhanced ultrasound imaging was a clsssical technique,but PTM’s application was more convenient and intuitive.VTQ was a new noninvasive ultrasonic examination technology developed afetr contrast-enhanced ultrasound and more concise.It also provided a obvious identification for the differential diagnosis of adapted HCC and hepatic hemangioma.