Comparison of contrast-enhanced ultrasound and contrast-enhanced helical CT in the diagnosis of high echo-level small focal liver lesions

Objective: To compare the diagnosis accurate rate of contrast-enhanced ultrasound (CEUS) and contrast enhanced helical CT (CECT) in high echo-level small focal liver lesions (HSFLLs) (diameter <= 3 cm), and to explore the application value of CEUS in the diagnosis and differential diagnosis of the benign and malignant liver hyperechoic lesions. Methods: The institutional review board of Tumor Hospital of Guangxi Medical University approved the study protocol. The CEUS Time intensity curves (TICs) results of 75 cases (107 lesions) with HSFLLs detected by two-dimensional ultrasound (2DUS) were reviewed and analyzed. And the results were compared with CECT. Results: The area under the curve of CEUS and CECT were 0.941 and 0.936 respectively. The cut off value of CEUS diagnosis for malignant lesions was 2.5. The sensitivity, specificity and the accuracy of CEUS for diagnosing malignant hepatic tumors were respectively 90.0%, 89.4% and 89.71%, versus 90.0%, 87.2% and 88.79% in CECT. The positive predictive value of CEUS and CECT were 0.895 and 0.875. The negative predictive value of CEUS and CECT were 0.101 and 0.103. In the diagnosis and differential diagnosis of cirrhotic nodules lesions and small hepatocellular carcinoma (SHCC) lesions, the accurate rate of CEUS was 92.86%, and CECT was 90.48%. Conclusion: CEUS could effectively and dynamically evaluate the hemodynamics of liver tumors, and provide qualitative and quantitative diagnosis to HSFLLs. In the diagnosis of HSFLLs and SHCC, CEUS was equal to CECT.