The Study Of HA-VTT Measurement With Contrast-Enhanced Ultrasonography In Diagnosising Hepatic Metastasis Of Digestive Cancer

ObjectiveTo assess the value of contrast-enhanced ultrasonography in Diagnosising hepatic metastasis of digestive cancer by measuring the hepatic artery to vein transit time (HA-VTT).Methods50liver disease patients (inclued35hepatic metastasis of digestive Cancer patients,15patients with benign liver lesions). In our study, Ultrasonography was used for all of these patients. According to number and size of tumor,50liver disease patients were divided to4groups (groupⅠ,13patients with single nodule and the size <1cm; groupⅡ,12patients with single nodule and the size>1and≦3cm; groupⅢ,10patients with multiple nodules or the size>3cm; groupⅣ,15patients with benign liver lesions). All groups were excluded patients with diffuse liver disease such as chronic viral hepatitis, Schistosoma cirrhosis and alcoholic cirrhosis. All hepatic metastasis were verified by pathology, the benign liver lesions were proved by CT enhancement, MRI and follow-up. After routine ultrasonic inspection, a bolus of SonoVue was injected into peripheral vein of these patients. The measurement of Hepatic artery transit time (HATT) and hepatic vein transit time (HVTT) in the liver tumors were performed. Then Hepatic artery to hepatic vein transit time(HA-VTT) were calculated by HVTT minus HATT.Measurement data was signed as mean±standard deviation (x±s).T test was used in2group measurement data and ANOVA test was used to analyzed more than2groups. P<0.05is consider as statistical significance.Results1. contrast-enhanced ultrasound can detect liver tumors less than1cm which can’t be detected by routine ultrasonic inspection. Our study showed that the minimum was0.8cm.2. The results of HA-VTT showed that the group Ⅱ(single nodule,>1cm and≦3cm;8s) and the group Ⅲ (multiple nodules or>3cm;6s) were significantly shorter than that of the group Ⅰ (single nodule and<1cm;11s) and the group Ⅳ (benign lesions;11s).3. There is no statistical differences of HA-VTT value between the liver metastasis group (Group Ⅰ,Ⅱ,Ⅲ)and hepatic benign lesion group (Group Ⅳ)(P>0.05). The subgroup analysis showed that there are statistically significant between the group Ⅱ(single nodule,>lcm and≦3cm),the group Ⅲ (multiple nodules or>3cm) and the group Ⅳ(benign lesions),(P<0.05).And the group Ⅲ and the group Ⅳ had significant difference (P<0.001).4. The HA-VTT values were statistically significant difference amang the group Ⅰ (single nodule and<lcm),the group Ⅱ(single nodule,>lcm and≦3cm) and the group Ⅲ (multiple nodules or>3cm)(P<0.001). And the HA-VTT value between the three liver metastasis groups(group Ⅰ,Ⅱ,Ⅲ) were no statistically difference (P>0.05).Conclusions1. Contrast-enhanced ultrasound is a successful measurement for detecting liver tumors less than1cm which can’t be detected by routine ultrasonic inspection.2. HA-VTT measurement of Diagnosising hepatic metastasis by Contrast-enhanced ultrasound with SonoVue is good at the hepatic metastasis larger than1cm or more than single. But the value is limited in the hepatic metastasis less than lcm, which needed to be combined with contrast ultrasound perfusion and other clinical detection means to identification.3. Our study showed that HA-VTT values mesured by contrast-enhanced ultrasound can be reference prediction index of whether the patients with gastroenteric tumor have metastases in liver. However, the duration was short, the cases was not enough and the self controlled study is still absent. The clinical value of this method will be further verificated with increasing cases and extending follow-up time.