Analysis Of The Consistency Between Contrast-enhanced Ultrasonography And MRI In The Detection Of Hepatic Alveolar Echinococcosis

【Objective】 In this paper,the imaging data of contrast-enhanced ultrasound and kodama classification of hepatic alveolar echinococcosis were compared and analyzed to observe the consistency of their biological activity in the evaluation of hepatic alveolar echinococcosis,so as to provide imaging reference for the treatment and follow-up of hepatic alveolar echinococcosis.【Methods】Contrast-enhanced ultrasound and MRI-related data of 47 patients who met the clinical diagnostic criteria for hepatic alveolar hydatid disease from October 1,2019 to December 30,2020 were collected in the Affiliated Hospital of Qinghai University.The examination parameters of all patients were the same,and the interval between the two examinations was less than one month.Contrast-enhanced ultrasound was performed with Sonovir(produced by Bracco,Italy),which is mainly composed of sulfur hexafluoride.The contrast process has three phases: arterial phase,portal phase and delayed phase,and then the images of the whole process are saved in DICOM format.The relevant parameters extracted from the time-intensity curve drawn by Sonoliver CAP software,such as peak intensity(PI),area under the curve(AUC),peak time(TP),and ROI,that is,the area of region of interest,were quantitatively analyzed.The Kodama typing of MRI was mainly observed in T2-SPAIR sequence,and MRCP and DWI sequence were used as auxiliary sequences to observe the structure of vesicles.The contrast-enhanced ultrasound and the small vesicles found in MRI’s Kodama classification were compared and analyzed to evaluate the consistency of their biological activity evaluation of hepatic alveolar echinococcosis.【Results】In 47 patients with HAE,77 HAE lesions were detected by MRI and contrast-enhanced ultrasound,and 5 more HAE lesions were detected by MRI than by contrast-enhanced ultrasound.Among the 77 lesions detected by contrast-enhanced ultrasound,the Kodama classification of MRI was 1 type 1,20 type 2,37 type 3,17 type 4 and 2 type 5,while 62 lesions(about 80.52%)showed bioactivity.Compared with MRI classification,there were 1 type 1(100%),20 type2(100%),33 type 3(about 89.19%)and 7 type 4(about 41.18%).1 type 5(50%).Among the 77 HAE lesions,MRI showed 53(68.83%)had small vesicle-like structure,24(31.17%)had no small vesicle-like structure,and all MRI showed small vesicle-like structure,and contrast-enhanced ultrasound showed enhancement.Both of them showed good consistency in monitoring the biological activity of HAE lesions(kappa=0.696).【Conclusion】 In HAE lesions,the small vesicle like structures showed by MRI classification were consistent with the microvascular imaging(enhancement)at the edge of the lesions detected by CEUS;CEUS is more complete and clearer than conventional ultrasound in showing HAE lesions.