Differential Diagnostic Value of Contrast-Enhanced Ultrasonography in Hepatocellular Carcinoma and Hepatic Hemangioma Patients with Hepatic Cirrhosis

Objective: To analyze the clinical value of contrast-enhanced ultrasonography(CEUS) in the diagnosis and differential diagnosis of hepatocellular carcinoma and hepatic hemangioma combined with hepatic cirrhosis.Methods: A total of 54 cases of hepatic cirrhosis combined with either hepatocellular carcinoma(n=31) or hepatic hemangioma(n=23),which were confirmed by pathology,were retrospectively studied.The results of conventional ultrasound,contrast-enhanced MRI,and pathological exam were compared with that of CEUS.Results: By CEUS,96.8%(30/31) hepatocellular carcinoma displayed swift enhancement in the arterial phase and swift expurgation in the portal phase,while only 3.2%(1/31) hepatocellular carcinoma was isoechoic in all phases;91.3%(21/23) hepatic hemangioma showed peripheral nodular enhancement in arterial phase and centripetal filling in portal phase and hypoenhancement in delayed phase,while only 8.7%(2/23) showed swift enhancement.The sensitivity,specificity,and accuracy rate in diagnosing hepatocellular carcinoma was respectively 61.3%,65.2%,and 63.0% by conventional ultrasound,96.8%,91.3%,and 94.4% by CEUS,and 93.5%,95.6%,and 94.4% by contrast-enhanced MRI were respectively.CEUS and contrast-enhance MRI were highly consistent with the pathological results(Kappa=0.89 and 0.89),and their correct rate of diagnosis were significantly higher than that of conventional ultrasound(Kappa=0.25).Conclusion: The characteristics of blood flow perfusion in hepatocellular carcinoma and hepatic hemangioma using CEUS are different.CEUS is better than conventional ultrasound in the diagnosis and differential diagnosis of hepatocellular carcinoma and hepatic hemangioma.