A diagnostic analysis of ultrasound elastography and contrast-enhanced ultrasound in focal liver lesions

Objective: To compare the diagnostic value of ultrasound elastography (UE) and contrast-enhanced ultrasound (CEUS) in focal liver lesions. Methods: Eighty-nine patients with focal liver lesions were included as subjects. All were examined by both UE and CEUS prior to the operation or puncture. The diagnostic accuracy of UE and CEUS was compared with puncture biopsy or postoperative pathological diagnosis results which served as gold standards. Results: Through the pathological diagnosis, the research subjects consisted of 42 patients with benign lesions and 55 patients with malignant lesions. The Kappa coefficient of the UE diagnosis for the focal liver lesions and the pathological diagnosis was 0.57 (P<0.05); the sensitivity, specificity and accuracy of the UE diagnosis for the malignant focal liver lesions were 76.36%, 80.95%, and 78.35%, respectively. The Kappa coefficient of the CEUS diagnosis for the focal liver lesions and pathological diagnosis was 0.81 (P<0.05); the sensitivity, specificity and accuracy of the CEUS diagnosis for the malignant focal liver lesions were 92.73%, 88.10%, and 90.72%, respectively. The analysis of the receiver operating characteristic (ROC) curve indicated that the area under the curve, the sensitivity, specificity, and accuracy of the diagnosis of UE combined with CEUS for malignant focal liver lesions were 0.90, 100%, 80.95% and 91.75%, respectively. Conclusion: UE can objectively reflect changes in the stiffness of focal liver lesions. CEUS reveals the changes of blood supply within the lesions in terms of microcirculation. Both methods have good diagnostic value. The combined application of UE and CEUS can improve diagnostic accuracy for focal liver lesions.