Comparison of Superb Microvascular Imaging With Color Flow and Power Doppler Imaging of Small Hepatocellular Carcinomas
Comparison of Superb Microvascular Imaging With Color Flow and Power Doppler Imaging of Small Hepatocellular Carcinomas
复制标题
DOI：
10.1002/jum.14654
复制
发表时间：
2018-12-01
影响因子：
2.3
通讯作者：
Erpelding, Todd
中科院分区：
文献类型：
--
作者：
Dubinsky, Theodore J.;Revels, Jonathan;Erpelding, Todd
目的比较Superb Microvascular Imaging（SMI; Toshiba America Medical Systems，Tustin，CA）与传统彩色血流多普勒（CFD）和能量多普勒（PD）显像在肝脏中鉴别良恶性肿瘤的价值。方法经机构审查委员会批准（编号449984-艾德）后，前瞻性识别2015年1月1日至2016年7月1日期间因直径小于2 cm的疑似肝细胞癌（HCC）接受常规射频消融前计划超声检查的患者。四名阅片者独立审查了超声图像，以确定病变中心和沿着周边是否存在血流。结果SMI的外周血管分级高于CFD（P < .001）和PD（P < .001）成像：特别是2级（分别为39%对16%和11%）和3级（分别为8%对0%和0%）。总的来说，对于肝癌（P <0.001）和良性病变（P <0.001），SMI比CFD和PD成像发现更多的中心和外周血管。在几乎所有病例中，HCC病变的血管分级显著高于良性病变，尽管相应的曲线下面积值相对较低，中心血管分级为0.54至0.59，外周血管分级为0.63至0.64。结论SMI比CFD和PD成像显示更多的肝脏病灶周围的中央和外周血管。虽然恶性肝脏病变的外周血管明显多于良性病变，但仅基于该标准的总体诊断性能相对较低，曲线下面积为0.64。
Objectives The purpose of this study was to compare Superb Microvascular Imaging (SMI; Toshiba America Medical Systems, Tustin, CA) with conventional color flow Doppler (CFD) and power Doppler (PD) imaging in the liver to distinguish between malignant and benign liver neoplasms. Methods After Institutional Review Board approval (number 449984-ED), patients undergoing routine pre-radiofrequency ablation planning ultrasound examinations for suspected hepatocellular carcinomas (HCCs) of less than 2 cm in diameter between January 1, 2015, and July 1, 2016, were prospectively identified. Four readers reviewed the ultrasound images independently for the presence or absence of flow centrally and along the periphery of the lesion. Results Higher peripheral vessel grades were found on SMI than CFD (P < .001) and PD (P < .001) imaging: in particular, more grade 2 (39% versus 16% and 11%, respectively) and grade 3 (8% versus 0% and 0%). Overall, more central and peripheral vessels were found on SMI than CFD and PD imaging for both HCC lesions (P < .001) and benign lesions (P < .001). Vascular grades were significantly higher in HCC lesions than benign lesions in nearly all cases, although the corresponding area under the curve values were relatively low, at 0.54 to 0.59 for the central vessel grades and 0.63 to 0.64 for the peripheral vessel grades. Conclusions More central and peripheral vessels were found around liver lesions on SMI than on CFD and PD imaging. Although there was significantly more vascularity on the periphery of malignant liver lesions than benign lesions, the overall diagnostic performance based on this criterion alone was relatively low, with an area under the curve of 0.64.