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Abstract：
OBJECTIVE: This study aimed to evaluate the diagnostic performance of high frame rate contrast-enhanced ultrasound (H-CEUS) of focal liver lesions (FLLs).
METHODS: From July 2017 to June 2019, conventional contrast-enhanced ultrasound (C-CEUS) and H-CEUS were performed in 78 patients with 78 nodules. The characteristics of C-CEUS and H-CEUS in malignant and benign groups and the differences between different lesion sizes (1-3 cm, 3-5 cm, or >5 cm) of C-CEUS and H-CEUS were examined. The diagnostic performance of C-CEUS and H-CEUS was analyzed. The chi-square test or Fisher\'s exact test was used to assess inter-group differences. The receiver operating characteristic curve was plotted to determine the diagnostic performance of C-CEUS and H-CEUS.
RESULTS: There were significant differences in the enhancement area, fill-in direction and vascular architecture between C-CEUS and H-CEUS for both benign and malignant lesions (all p=0.000-0.008), but there were no significant differences in washout results (p=0.566 and p=0.684, respectively). For lesions 1-3 cm in size, the enhancement area, fill-in direction, and vascular architecture on C-CEUS and H-CEUS were significantly different (all p=0.000), unlike for lesions 3-5 cm or >5 cm in size. For differentiation of malignant from benign FLLs in the 1-3 cm group, H-CEUS showed sensitivity, specificity, accuracy, and positive and negative predictive values of 92.86%, 95.0%, 96.3%, 90.48% and 93.75%, respectively, which were higher than those for C-CEUS (75.0%, 70.0%, 77.78%, 66.67% and 72.91%, respectively).
CONCLUSIONS: H-CEUS provided more vascular information which could help differentiate malignant from benign FLLs, especially for lesions 1-3 cm in size.
METHODS: From July 2017 to June 2019, conventional contrast-enhanced ultrasound (C-CEUS) and H-CEUS were performed in 78 patients with 78 nodules. The characteristics of C-CEUS and H-CEUS in malignant and benign groups and the differences between different lesion sizes (1-3 cm, 3-5 cm, or >5 cm) of C-CEUS and H-CEUS were examined. The diagnostic performance of C-CEUS and H-CEUS was analyzed. The chi-square test or Fisher\'s exact test was used to assess inter-group differences. The receiver operating characteristic curve was plotted to determine the diagnostic performance of C-CEUS and H-CEUS.
RESULTS: There were significant differences in the enhancement area, fill-in direction and vascular architecture between C-CEUS and H-CEUS for both benign and malignant lesions (all p=0.000-0.008), but there were no significant differences in washout results (p=0.566 and p=0.684, respectively). For lesions 1-3 cm in size, the enhancement area, fill-in direction, and vascular architecture on C-CEUS and H-CEUS were significantly different (all p=0.000), unlike for lesions 3-5 cm or >5 cm in size. For differentiation of malignant from benign FLLs in the 1-3 cm group, H-CEUS showed sensitivity, specificity, accuracy, and positive and negative predictive values of 92.86%, 95.0%, 96.3%, 90.48% and 93.75%, respectively, which were higher than those for C-CEUS (75.0%, 70.0%, 77.78%, 66.67% and 72.91%, respectively).
CONCLUSIONS: H-CEUS provided more vascular information which could help differentiate malignant from benign FLLs, especially for lesions 1-3 cm in size.
摘要：
目的：本研究旨在评估高帧率超声造影（H-CEUS）对局灶性肝脏病变（FLL）的诊断性能。
方法：2017年7月至2019年6月，对78例结节患者行常规超声造影（C-CEUS）和H-CEUS检查。恶性和良性组C-CEUS和H-CEUS的特征以及不同病灶大小（1-3cm，3-5厘米，或>5cm）的C-CEUS和H-CEUS检查。分析了C-CEUS和H-CEUS的诊断性能。卡方检验或Fisher精确检验用于评估组间差异。绘制受试者工作特性曲线以确定C-CEUS和H-CEUS的诊断性能。
结果：增强区域有显著差异，良性和恶性病变的C-CEUS和H-CEUS之间的填充方向和血管结构（所有p=0.000-0.008），但冲洗结果没有显着差异（分别为p=0.566和p=0.684）。对于1-3厘米大小的病变，增强区域,填充方向,C-CEUS和H-CEUS上的血管结构存在显着差异（所有p=0.000），与大小为3-5厘米或>5厘米的病变不同。为了区分1-3厘米组的恶性和良性FLL，H-CEUS显示敏感性,特异性，准确度,阳性和阴性预测值为92.86%，95.0%,96.3%,90.48%和93.75%，分别,高于C-CEUS(75.0%，70.0%,77.78%,66.67%和72.91%，分别)。
结论：H-CEUS提供了更多的血管信息，可以帮助区分恶性和良性FLL，特别是1-3厘米大小的病变。
方法：2017年7月至2019年6月，对78例结节患者行常规超声造影（C-CEUS）和H-CEUS检查。恶性和良性组C-CEUS和H-CEUS的特征以及不同病灶大小（1-3cm，3-5厘米，或>5cm）的C-CEUS和H-CEUS检查。分析了C-CEUS和H-CEUS的诊断性能。卡方检验或Fisher精确检验用于评估组间差异。绘制受试者工作特性曲线以确定C-CEUS和H-CEUS的诊断性能。
结果：增强区域有显著差异，良性和恶性病变的C-CEUS和H-CEUS之间的填充方向和血管结构（所有p=0.000-0.008），但冲洗结果没有显着差异（分别为p=0.566和p=0.684）。对于1-3厘米大小的病变，增强区域,填充方向,C-CEUS和H-CEUS上的血管结构存在显着差异（所有p=0.000），与大小为3-5厘米或>5厘米的病变不同。为了区分1-3厘米组的恶性和良性FLL，H-CEUS显示敏感性,特异性，准确度,阳性和阴性预测值为92.86%，95.0%,96.3%,90.48%和93.75%，分别,高于C-CEUS(75.0%，70.0%,77.78%,66.67%和72.91%，分别)。
结论：H-CEUS提供了更多的血管信息，可以帮助区分恶性和良性FLL，特别是1-3厘米大小的病变。
