The value of contrast-enhanced ultrasound parametric imaging in the differential diagnosis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma

YIN Lulu; XUE Haiyan; KONG Wentao

Abstract：Objective To investigate the value of contrast-enhanced ultrasound(CEUS)parametric imaging in the differen-tial diagnosis of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).Methods 157 patients with pri-mary liver cancer confirmed by surgery or puncture pathology were retrospectively analyzed,including 76 cases of HCC and 81 cases of ICC.The resolution of images displayed in different modes was divided into 0 to 3 points,and the resolution of gray scale ultrasound,contrast-enhanced ultrasound and parametric imaging in the two diseases was analyzed.The parametric imaging modes of CEUS post-processing were divided into 0-3 categories,and the differences of the two parametric imaging modes and their diagnostic efficiency were compared.Results 1)For the tumor with maximum diameter less than 3cm,both the sensitivity and positive predictive value were 80.7%when parametric imaging classification 1 as a diagnostic criterion for HCC.Whereas,the sensitivity and positive predictive value were 22.2%and 100%for ICC when classification 3 as a diagnostic criterion,both of which were higher than those of the tumor with maximum tumor diameter＞3cm;2)Parametric imaging classification 1 was the primary type of HCC group,accounting for 68.4%.The proportion was significantly higher than that in ICC group,with statistical significance(P＜0.001);and 3)Multimodal US showed there was a statistically significant difference between HCC and ICC group in the constituent ratio of clarity score(P<0.01).Conclusion The arterial phase of CEUS and parametric imaging shows better clarity for HCC than for ICC.HCC and ICC have different types on parametric imaging,which is helpful for differential di-agnosis.