Abstract：
OBJECTIVE: In high-BMI patients with and without fatty liver, we evaluate performance of a commercially available specially designed ultrasound probe (SDP) for scanning at depth. Greyscale and contrast-enhanced ultrasound (CEUS) capability of SDP for parenchymal assessment and liver mass characterization, emphasizing HCC, is compared with standard curvilinear probes.
METHODS: This retrospective study included 60 patients. Fifty-five with measured BMI included 46/55 (84%) overweight or obese, and 9/55(16%) in the normal range with severe fatty liver. Fifty-six patients with focal liver abnormality included 37 with a mass and 19 with post-ablative treatment site. Masses included 23 confirmed malignancies, 15 HCC, 4 ICC, and 4 metastases. SDP followed suboptimal ultrasound using a standard probe. Images with varying fat content were compared for depth of penetration on greyscale and ability of CEUS to diagnose tumors.
RESULTS: SDP showed statistically significant improvement P = <.05 in CEUS penetration for all degrees of fatty liver (mild, moderate, and severe). In malignant tumors, SDP improved detection of lesion washout in the portal venous/late phase (PVP/LP) at depth >10 cm, and in all malignant masses (P < .05). Fifteen confirmed deep HCC showed arterial phase hyperenhancement on standard probe in 10/15 (67%) and 15/15 (100%) on SDP. PVP/LP washout on standard probe was shown in 4/15 (26%) and on SDP, 14/15, (93%). Therefore, 93% of LR-5 tumors were diagnosed with SDP. Removing necessity for biopsy.
CONCLUSIONS: Metabolic syndrome and obesity challenge ultrasound, especially CEUS. SDP overcame limitations of standard probes for CEUS penetration especially in fatty liver. SDP was optimal for the liver mass characterization by detecting washout.
METHODS: This retrospective study included 60 patients. Fifty-five with measured BMI included 46/55 (84%) overweight or obese, and 9/55(16%) in the normal range with severe fatty liver. Fifty-six patients with focal liver abnormality included 37 with a mass and 19 with post-ablative treatment site. Masses included 23 confirmed malignancies, 15 HCC, 4 ICC, and 4 metastases. SDP followed suboptimal ultrasound using a standard probe. Images with varying fat content were compared for depth of penetration on greyscale and ability of CEUS to diagnose tumors.
RESULTS: SDP showed statistically significant improvement P = <.05 in CEUS penetration for all degrees of fatty liver (mild, moderate, and severe). In malignant tumors, SDP improved detection of lesion washout in the portal venous/late phase (PVP/LP) at depth >10 cm, and in all malignant masses (P < .05). Fifteen confirmed deep HCC showed arterial phase hyperenhancement on standard probe in 10/15 (67%) and 15/15 (100%) on SDP. PVP/LP washout on standard probe was shown in 4/15 (26%) and on SDP, 14/15, (93%). Therefore, 93% of LR-5 tumors were diagnosed with SDP. Removing necessity for biopsy.
CONCLUSIONS: Metabolic syndrome and obesity challenge ultrasound, especially CEUS. SDP overcame limitations of standard probes for CEUS penetration especially in fatty liver. SDP was optimal for the liver mass characterization by detecting washout.
摘要：
目标：在有和没有脂肪肝的高BMI患者中，我们评估了用于深度扫描的市售专门设计的超声探头（SDP）的性能。SDP用于实质评估和肝脏质量表征的灰度和超声造影（CEUS）能力，强调HCC，与标准曲线探针进行比较。
方法：这项回顾性研究包括60例患者。测量BMI的55人包括46/55（84％）超重或肥胖，9/55（16％）在正常范围内患有严重脂肪肝。56例局灶性肝脏异常患者包括37例肿块和19例消融后治疗部位。群众包括23个确诊的恶性肿瘤，15HCC，4ICC,和4个转移。SDP使用标准探头跟随次优超声。比较了不同脂肪含量的图像的灰度穿透深度和CEUS诊断肿瘤的能力。
结果：SDP显示出统计学上的显着改善，P=<0.05对于所有程度的脂肪肝（轻度，中度,和严重）。在恶性肿瘤中，SDP改善了门静脉/晚期（PVP/LP）深度>10cm时病变冲洗的检测，在所有恶性肿块中（P<0.05）。15个确诊的深层HCC在SDP的10/15（67％）和15/15（100％）的标准探针上显示动脉期过度增强。4/15(26%)和SDP显示标准探头上的PVP/LP洗脱,14/15，（93%）。因此,93%的LR-5肿瘤被诊断为SDP。去除活检的必要性。
结论：代谢综合征和肥胖挑战超声，尤其是CEUS。SDP克服了CEUS渗透标准探针的局限性，尤其是在脂肪肝中。通过检测冲洗，SDP对于肝脏质量表征是最佳的。
方法：这项回顾性研究包括60例患者。测量BMI的55人包括46/55（84％）超重或肥胖，9/55（16％）在正常范围内患有严重脂肪肝。56例局灶性肝脏异常患者包括37例肿块和19例消融后治疗部位。群众包括23个确诊的恶性肿瘤，15HCC，4ICC,和4个转移。SDP使用标准探头跟随次优超声。比较了不同脂肪含量的图像的灰度穿透深度和CEUS诊断肿瘤的能力。
结果：SDP显示出统计学上的显着改善，P=<0.05对于所有程度的脂肪肝（轻度，中度,和严重）。在恶性肿瘤中，SDP改善了门静脉/晚期（PVP/LP）深度>10cm时病变冲洗的检测，在所有恶性肿块中（P<0.05）。15个确诊的深层HCC在SDP的10/15（67％）和15/15（100％）的标准探针上显示动脉期过度增强。4/15(26%)和SDP显示标准探头上的PVP/LP洗脱,14/15，（93%）。因此,93%的LR-5肿瘤被诊断为SDP。去除活检的必要性。
结论：代谢综合征和肥胖挑战超声，尤其是CEUS。SDP克服了CEUS渗透标准探针的局限性，尤其是在脂肪肝中。通过检测冲洗，SDP对于肝脏质量表征是最佳的。
