Usefulness of Sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and superparamagnetic iron oxide magnetic resonance images
Usefulness of Sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and superparamagnetic iron oxide magnetic resonance images
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DOI：
10.1007/s00535-009-0053-7
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发表时间：
2009-07-01
影响因子：
6.3
通讯作者：
Sakaida, Isao
中科院分区：
文献类型：
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作者：
Korenaga, Keiko;Korenaga, Masaaki;Sakaida, Isao
目的探讨索纳佐德超声造影(Sonazid-CEUS)在肝细胞癌诊断中的价值。Sonazid-CEUS的Kupffer期图像与超顺磁性氧化铁磁共振成像(SPIO-MRI)进行比较。方法48个经组织学诊断的肝癌结节，其中高分化型13个，中分化型30个，低分化型5个。我们对所有受试者行Sonazid-CEUS和SPIO-MRI检查。在Sonazid-CEUS的Kupffer相中，肿瘤区域和非肿瘤区域之间对比剂摄取的差异被量化为Kupffer时相比率，并进行比较。在SPIO-MRI中，将其量化为SPIO强度指数。结果随着肝癌分化程度的降低，Kupffer时相比例降低(P<；0.0001；Kruskal-Wallis检验)。随着肝癌分化程度的降低，SPIO强度指数也随之降低(P<；0.0001)。Kupffer时相比例与SPIO-MRI指数呈正相关(r=0.839)。在Sonazid-CEUS的Kupffer期，所有中、低分化型肝癌均呈低回声，表现为灌注缺陷，而高分化型肝癌大部分(9/13例，69.2%)呈等回声。Sonazid-CEUS与SPIO-MRI的Kupffer时相图像在所有中、低分化型肝癌中的符合率均为100%。结论Sonazid-CEUS有助于判断肝癌的组织学分级。这是一种有可能取代SPIO-MRI的检查方式。
Objective We investigated the usefulness of Sonazoid contrast-enhanced ultrasonography (Sonazoid-CEUS) in the diagnosis of hepatocellular carcinoma (HCC). The examination was performed by comparing the images during the Kupffer phase of Sonazoid-CEUS with superparamagnetic iron oxide magnetic resonance (SPIO-MRI).Methods The subjects were 48 HCC nodules which were histologically diagnosed (well-differentiated HCC, n = 13; moderately differentiated HCC, n = 30; poorly differentiated HCC, n = 5). We performed Sonazoid-CEUS and SPIO-MRI on all subjects. In the Kupffer phase of Sonazoid-CEUS, the differences in the contrast agent uptake between the tumorous and non-tumorous areas were quantified as the Kupffer phase ratio and compared. In the SPIO-MRI, it was quantified as the SPIO-intensity index. We then compared these results with the histological differentiation of HCCs.Results The Kupffer phase ratio decreased as the HCCs became less differentiated (P < 0.0001; Kruskal-Wallis test). The SPIO-intensity index also decreased as HCCs became less differentiated (P < 0.0001). A positive correlation was found between the Kupffer phase ratio and the SPIO-MRI index (r = 0.839). In the Kupffer phase of Sonazoid-CEUS, all of the moderately and poorly differentiated HCCs appeared hypoechoic and were detected as a perfusion defect, whereas the majority (9 of 13 cases, 69.2%) of the well-differentiated HCCs had an isoechoic pattern. The Kupffer phase images of Sonazoid-CEUS and SPIO-MRI matched perfectly (100%) in all of the moderately and poorly differentiated HCCs.Conclusion Sonazoid-CEUS is useful for estimating histological grading of HCCs. It is a modality that could potentially replace SPIO-MRI.