Contrast-enhanced ultrasound and its differential diagnosis in 21 patients with intrahepatic space-occupying lesions under the background of fatty liver

Abstract

Background: The sonographic appearance in intrahepatic space-occupying lesions under the background of fatty liver is atypical. This study aimed to explore the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of intrahepatic space-occupying lesions under the background of fatty liver. Methods: Twenty-one patients with intrahepatic space-occupying lesions under the background of fatty liver who were treated in our hospital from January 2017 to September 2020 and met the inclusion/ exclusion criteria were enrolled in this study. The clinical and imaging data, size, location, shape, and other characteristics of the lesions were analyzed. The accuracy of conventional ultrasound and contrast-enhanced ultrasound in diagnosing intrahepatic space-occupying lesions under the background of fatty liver were compared. Results: The 21 patients had moderate to severe fatty liver, including 11 cases with malignant lesions (52.38%) and 10 cases with benign lesions (47.62%). The accuracy of CEUS (90.48%) was significantly higher than that of conventional ultrasound (61.90%) in diagnosing intrahepatic space-occupying lesions under the background of fatty liver. A total of 33 lesions were detected in 21 patients, which were hypoechoic. Liver abscesses mainly showed ring-shaped enhancement in the arterial phase and low enhancement in the portal phase, with abscess necrosis in the center and no significant enhancement. Liver cyst lesions showed no significant enhancement in the arterial, portal, and delayed phases. The three stages of focal fat loss were synchronized and simultaneously enhanced with surrounding fatty liver tissues. The area under the diagnostic curve of conventional ultrasound and CEUS was 0.668 and 0.809, respectively, and the area under the curve of CEUS detection was the largest (P<0.05). Conclusions: CEUS can effectively improve the diagnostic accuracy of intrahepatic space-occupying lesions under the background of fatty liver, and is an effective means to differentially diagnose intrahepatic space-occupying lesions under the background of fatty liver.

Focal solitary necrotic nodules in fatty liver: characteristics on conventional and contrast-enhanced ultrasonography

“…Low mechanical index (MI) real-time CEUS has greatly improved the differential diagnosis of focal liver lesions [5,[13][14][15]. Because of the increasing incidence of focal lesions in patients with fatty liver in recent years, some cases of SNNs in the liver have been collected since we have researched focal lesions in fatty liver for many years.…”