Diagnostic value of color parametric imaging and contrast‐enhanced ultrasound in the differentiation of hepatocellular adenoma and well‐differentiated hepatocellular carcinoma

• Published in: Journal of clinical ultrasound 2022-02, Vol.50 (2), p.216-221
• Main Authors: Liu, Yu‐Hui, Fan, Zhi‐Hui, Yin, Shan‐Shan, Yan, Kun, Sun, Li‐Qi, Jiang, Bin‐Bin
• Format: Article
• Language: English
• Subjects: Adenoma; Adenoma, Liver Cell - diagnostic imaging; Carcinoma, Hepatocellular - diagnostic imaging; Color; Contrast Media; contrast‐enhanced BR1; Diagnosis; Diagnosis, Differential; Diagnostic systems; Differential diagnosis; Hepatocellular carcinoma; Humans; Liver cancer; liver cell adenoma; Liver Neoplasms - diagnostic imaging; Medical imaging; Retrospective Studies; Sensitivity and Specificity; Tumors; Ultrasonic imaging; Ultrasonography; Ultrasound; well‐differentiated
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.23138

Purpose To investigate the differential diagnostic value of computer‐aided color parametric imaging (CPI) and contrast‐enhanced ultrasound (CEUS) in hepatocellular adenoma (HCA) and well‐differentiated hepatocellular carcinoma (wHCC). Method A total of 38 patients who underwent CEUS and were pathologically diagnosed with HCA (10 cases) and wHCC (28 cases) were reviewed retrospectively. The differences between the radiological features of HCA and wHCC were compared by two readers, blinded to the final diagnosis. Results (a) Sonographic features: on gray‐scale ultrasound, halo sign was more common in wHCC than in HCA (60.7% vs. 10.0%, p = 0.009). On CEUS, hyper‐ or isoenhancement was more common in HCA in the portal phase (90.0% vs. 50.0%; p = 0.022). On CPI mode, HCA was inclined toward centripetal enhancement (60.0% vs. 14.3% p = 0.010). HCA was characterized by the presence of pseudocapsule enhancement (50.0% vs. 14.3%; p = 0.036). Quantitative analysis showed that the arrival time of HCA was earlier than that of wHCC (12.4 ± 3.7 s vs. 15.9 ± 3.2 s; p = 0.006). (b) Interobserver agreement was improved by using CPI compared with CEUS. The diagnostic sensitivity, specificity, and accuracy of the combination were 80.0%, 85.7%, and 84.2%, respectively. Conclusions CEUS combined with CPI can provide effective information for the differential diagnosis of HCA and wHCC, especially for the non‐experienced radiologists. Comparison of enhancement modes shown in CEUS and CPI (a‐d: centripetal, centrifugal, homogeneous and indeterminate on CEUS; e‐h: centripetal, centrifugal, homogeneous and indeterminate on CPI)