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Value of wash‐in and wash‐out time in the diagnosis between hepatocellular carcinoma and other hepatic nodules with similar vascular pattern on contrast‐enhanced ultrasound
Author(s) -
Kong WenTao,
Wang WenPing,
Huang BeiJian,
Ding Hong,
Mao Feng
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12394
Subject(s) - medicine , hepatocellular carcinoma , ultrasound , radiology , carcinoma , value (mathematics) , contrast (vision) , pathology , machine learning , artificial intelligence , computer science
Background and Aim The study aims to demonstrate whether the wash‐in and wash‐out time can be reliable as a criterion in the differential diagnosis between hepatocellular carcinoma ( HCC ) and other hepatic nodules with vascular pattern similar to HCC on contrast‐enhanced ultrasound ( CEUS ). Methods From F ebruary 2012 to F ebruary 2013, 214 patients with hepatic nodules displayed rapid hyperenhancement and quick wash‐out on CEUS were included in this study. Before performing CEUS , all nodules were examined by grayscale ultrasonography and color D oppler techniques. CEUS was performed with SonoVue and low mechanical index technique. The initial time to enhancement, time to peak, time of the nodule being hypoenhanced were comparatively studied between HCCs and other hepatic nodules. Results Of all the 214 nodules, 209 were malignant (164 HCCs , 31 metastases, 10 intrahepatic cholangiocarcinomas ( ICCs ), 3 combined hepatocellular‐cholangiocarcinomas, 1 epithelioid hemangioendothelioma), and five were benign (two inflammatory pseudotumors, one focal nodular hyperplasia nodule, one hemangioma, and one hyperplastic nodule). Metastases and ICCs showed more rapid wash‐out than HCCs ( P < 0.05): 16 of 31 metastases and 7 of all ICCs showed wash‐out by 40 s after injection. Conclusions Some focal liver lesions can show enhancement pattern similar to HCCs on CEUS . The wash‐out time may be useful in the differential diagnosis.