Research On The Application Value Of Multimodal Ultrasound Technology In The Marginal Zone Of Hepatic Alveolar Echinococcosis

Objective: To explore the application value of multimodal ultrasound technique in evaluating the biological boundary and microcirculation perfusion in the marginal zone of hepatic alveolar echinococcosis(HAE).Methods: The patients with HAE confirmed by pathology after surgery in Sichuan Provincial People’s Hospital,from October 2021 to January 2023,were included in this study.Before surgery,the patients were examined by gray scale ultrasound,contrast enhanced ultrasound(CEUS)and shear wave elastography(SWE).All lesions were grouped according to Ulm classification.After surgery,the microvessel density(MVD)in the marginal zone of the lesions was counted under the microscope.All relevant parameters were statistically analyzed.Results: 1.53 lesions(a total of 46 patients,21 males and 25 females)were finally selected in this study,including 22 hemangioma-like classification lesions,17 hailstorm classification lesions and 14 pseudocystic classification lesions.The maximum diameter,perimeter and area of all lesions after CEUS were significantly greater than the gray scale values of the same section(p<0.05).2.Under CEUS,the maximum width of the marginal zone of different classification lesions had different overall distribution,which showed that the pseudocystic classification lesions were significantly larger than the hemangioma-like classification lesions(p<0.05),and the other two classification lesions had no significant difference(p>0.05).3.The CEUS parameters(Mean transmit time(MMT),Time to peak(TTP),Peak intensity(PI),SLOPE,Area under the curve(AUC))of the marginal zone of different classification lesions had different overall distribution,which all showed that the pseudocystic classification lesions were significantly smaller than the hemangioma-like classification lesions and hailstorm classification lesions(p<0.05),and there was no significant difference between the latter two classification lesions(p > 0.05).4.Emean in the marginal zone of the lesions was significantly different from adjacent liver tissue and the distant normal liver tissue(p<0.05);There was no significant difference in Emean in the marginal zone of different classification lesions(p>0.05).5.The MVD value of the marginal zone of different classification lesions had different overall distribution,which showed that the pseudocystic classification lesions were significantly smaller than the hemangioma-like classification lesions and hailstorm classification lesions(p<0.05),and there was no significant difference between the latter two classification lesions(p>0.05).6.The PI and AUC were significantly positively correlated with MVD of the marginal zone of different classification lesions(r>0,p<0.05),and there was no significant difference in the SWE value(Emean)of the marginal zone of different classification lesions(p>0.05).Conclusions: 1.Gray scale ultrasound is failed to show the true biological boundary of HAE.The marginal zone of HAE of different Ulm classifications which based on sonomorphological patterns has not the same microcirculation perfusion.2.CEUS can clearly show the marginal zone of HAE,and the maximum width of the marginal zone of different classifications of HAE has different overall distribution.And there is a significant positive correlation between the maximum width of the marginal zone and the maximum diameter of HAE.3.CEUS quantitative parameters can be used to analyze the microcirculation perfusion of the marginal zone.4.SWE can provide valid information in the exploration of the biological boundary of HAE,but the application value of SWE in in evaluating microcirculation perfusion in the marginal zone of lesions with different Ulm classifications has not yet been found.