The Value Of Ultrasound In Diagnosis Of Pediatric Superficial Hemangioma In Different Stage

Objective: To explore the application of color Doppler flow imaging, quantitativeparameters of ultrasonic elastography and three-dimensional color power angiographin diagnosis of pediatric superficial hemangioma in different stage.Methods:39hemangioma in two-dimensional ultrasonography were observed fromtheir size, shape, internal texture, and its relations with the surrounding tissue andblood flow. To examine their peak arterial systolic flow velocity and resistance index.They underwent real—time ultrasonic elastography to distinguish elasticity score. Byusing elastic Q analysis software，the EIA(E1astography index，EIA)Values of aimednodules were determined．And the values were compared with that of normaltissue(EIB)．The ratio Values of them were obtained．VI, FI and VFI of tumors arefound by virtue of observation on tumors’ blood perfusion in3D-CPA, andthree-dimensional image is collected, and then these parameters are obtained by usingVOCAL.Pathological examination is explored on removed tumors after operation.Then the hemangioma is categorized as tumors in proliferative stage, tumors ininvoluting phase,accoding to the expressing of the Ki-67. Both the two and threedimension ultrasound and their elastography features of former two forms of tumorsare studied, along with the comparison analysis on them.Results:1.39hemangioma are, according to their medical history and physical sign,re-staged by Ki-67. The result proceeds as follows: hemangioma in proliferative stagetakes place on24cases, hemangioma in involuting stage15cases.2. Ultrasonogram of hemangioma in proliferative stage indicates mixedecho crumbs or low echo crumbs, in which the blood signals perform drastically.Spectral doppler indicates that the blood signals are rteriovenous, and the arteryblood’s flow spectrum presents high speed and low resistance. At the same time, thephenomenon of much more vascular cavity gap closure caused by fibrosis andcalcification in shown in tumors in involuting phase. Its ultrasonogram signals hyperechogenicity, and sparse distribution of color blood flow signals is seen.3. PASV of tumors in proliferative stage and in involuting phase is respectively(44.36±15.25)cm/s and（31.12±11.93）cm/s, the discrepancy is obvious(t=2.86，P＜0.01). RI is0.53±0.08、0.60±0.07, respectively, the discrepancy is obvious,too((t=-3.04，P＜0.01). Respectively, elastography of tumors of is mainly blue coloror green-red, mainly blue color or blue--green, and elastic calculation is respectivelyshown as (2.83±0.87) and (3.20±1.08), the discrepancy has no statisticsmeanings(t=-1.12,P＞0.05). EIA comes out as2.50±0.97and2.33±1.07, thediscrepancy has no statistics meanings(t=0.51, P＞0.05). Ratio is2.01±0.86and1.78±0.94, the discrepancy has no statistics meanings(t=0.79,P＞0.05). VI is observedas0.51±0.11and0.32±0.15，the discrepancy presents significant(t=4.51，P＜0.01). FI38.06±6.64and30.81±10.29，the discrepancy has no statistics meanings (t=2.68，P＜0.05). VFI19.54±5.52and11.07±6.47, the discrepancy shows significant ((t=4.36，P＜0.01).4. Of5analyzed items, area under the curve (AUC) of ROC presents the largestone. Being critical point, the proportion of VI≥45.0%is studied. The results proceedas follows: the diagnosis of sensibility of tumors in proliferative stage is79.2%,specificity80.0%，positive predictive value86.4%，negative predictive value70.6%.Conclusion:1. There exists difference among PASV, RI, VI, FI,VFI of tumors inproliferative stage and in involuting phase. The results of hemangioma’s specificityand positive predict valu in different stage obtained from VI is higher than that ofPASV, RI, FI, VFI.2. Obvious clinical application value of elastography in diagnosis ofhemangioma in different stage cannot be seen.