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Abstract
Aim. To analyze the diagnostic efficiency of multiparametric contrast-enhanced ultrasound in the differential diagnosis of focal liver lesions in cancer patients and obtain data from computed tomography and histological findings.
Materials and methods. A retrospective analysis of the results of studies of 123 patients with focal liver lesions was carried out, including 96 women (mean age 56.1 ± 13.6) and 27 men (mean age 55.0 ± 14.0). All patients underwent multiparametric ultrasound and contrast-enhanced computed tomography. If a malignant process was suspected (n=72), a core-biopsy was performed under ultrasound guidance. In case of detection of signs characteristic of benign lesions, patients under dynamic control are characterized by 3 months in the first year of observation, the absence of dynamics after 6-12 months of observation is the total when using a benign process. Morphological verification was also performed when selecting the size of the lesion.
Results. Results for the B-mode ultrasound: sensitivity (Se) -58.1%, specificity (Sp) -68.4%, accuracy (A) -60.2%, positive predictive value (PPV) - 87.8%, negative predictive value (NPV) is 29.5%. The effectiveness of contrast enhanced ultrasound (CEUS) significantly exceeded the study in the traditional gray scale mode and amounted to: Se-90.5%, Sp-84.2%, A-89.2%, PPV-95.7%, NPV-69.6%. For computed tomography (CT), the results were comparable with CEUS and amounted to: Se-83.6%, Sp-78.9%, A-82.6%, PPV-93.8%, NPV-55.6%.
The values obtained by us confirm the high informativeness of CEUS in assessing focal liver lesions, and therefore in some cases (lack of technical feasibility or contraindications to CT, as well as ambiguous results obtained by other methods) can act as a method of choice.
Conclusion. Multimodal diagnostics is superior to a single imaging method in terms of screening sensitivity and diagnostic accuracy. CECT and CEUS complement each other in the differential diagnosis of liver lesions of unknown origin. The use of CECT in combination with CEUS shows clinical value for patients, which is especially important in patients with burdened oncological disease.
References
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