Contrast-Enhanced Ultrasound Findings and Differential Diagnosis of Hepatic Epithelioid Angiomyolipoma Compared with Hepatocellular Carcinoma |
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| Institution: | 2. Department of Medical Ultrasound, Wuhan Center Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;3. Department of Medical Ultrasound, Third People''s Hospital of Hubei Province, Wuhan, China;2. Pathology Department, Peking University People''s Hospital Beijing, China;2. Interdisciplinary Ultrasound Center, University Hospital Marburg and Philipps University Marburg, Marburg, Germany;3. Department of Medical Informatics, Biometrics and Epidemiology, Ruhr University Bochum, Bochum, Germany;2. Department of Electrical and Computer Engineering, University of Illinois at Urbana–Champaign, Urbana, Illinois, USA;3. Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Urbana, Illinois, USA;2. Department of Ultrasound, Sixth People''s Hospital of Zhengzhou, Zhengzhou, China;3. Department of Ultrasound, First People''s Hospital of Yueyang, Yueyang, China;4. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;5. Department of Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China |
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| Abstract: | Hepatic epithelioid angiomyolipoma (EAML) has malignant potential that can easily be misdiagnosed as hepatocellular carcinoma (HCC), but the treatment options of these conditions are different. This retrospective study investigated whether contrast-enhanced ultrasound (CEUS) can differentiate EAML from HCC. We included 24 patients with pathologically confirmed EAML and 36 patients with HCC who underwent pre-operative conventional ultrasound and CEUS. The conventional ultrasound and CEUS features of the two groups were analyzed. Time intensity curves (TICs) were analyzed for all lesions using quantitative perfusion analysis software. This study found that significant differences existed between the EAML and HCC groups in terms of clinical features such as sex, age, symptoms, alpha-fetoprotein and history of hepatitis B virus infection (p < 0.05). Tumor size, number, border and echogenicity on conventional ultrasound were significantly different between EAML and HCC (p < 0.05). Regarding CEUS, EAML was more likely to have a centripetal enhancement pattern than HCC (p < 0.05). The tumor enhancement degree in the delayed phase in CEUS was significantly different between EAML and HCC (p < 0.05). Quantitative analysis of CEUS parameters revealed that the wash-in area under the curve (AUC) was larger in EAML than in HCC (p < 0.05). Time to peak was significantly shorter in EAML than in HCC (p < 0.05). The peak intensity was significantly stronger in EAML than in HCC (p < 0.05). Regarding the diagnostic performance of CEUS parameters that showed statistical significance on univariate analysis, the sensitivity and specificity for distinguishing EAML from HCC was 66.7%–100.0% and 55.6%–91.7%, respectively. Overall, CEUS could be valuable in differentiating EAML from HCC. Specific features such as the centripetal filling and prolonged enhancement patterns on CEUS, higher peak intensity, bigger wash-in AUC and shorter time to peak on TICs may contribute to a more confirmative differential diagnosis of EAML. |
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