Application of contrast-enhanced ultrasound in the diagnosis of liver solid-cystic lesions

Abstract

Background: Liver solid-cystic lesions are diverse in type, and accurate differential diagnosis is of great clinical significance. This study aimed retrospectively analyze the sonographic features of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in liver solid-cystic lesions, and to compare their diagnostic performance.

Methods: A total of 157 patients with liver solid-cystic lesions diagnosed by US from January 2011 to November 2024 were retrospectively collected. The clinical features, US and CEUS features of 157 lesions were summarized. The diagnostic performance of CEUS was compared with US and contrast-enhanced computed tomography (CECT) in the evaluation of liver solid-cystic lesions.

Results: This study included 157 lesions comprising 87 benign lesions (37 liver abscesses, 30 hepatic echinococcosis, 8 cysts, and 12 other benign lesions), 8 borderline tumors (5 intraductal papillary neoplasms of the bile duct and 3 mucinous cystic neoplasms), and 62 malignant tumors (24 metastatic carcinomas, 19 hepatocellular carcinomas, 14 intrahepatic cholangiocarcinomas, and 5 other malignant neoplasms).The diagnostic accuracy of US for liver solid-cystic lesions was 64.3 % (95 % confidence interval [CI]: 56.7 %- 72.0 %), while that of CEUS was 84.1 % (95 % CI: 77.9-90.5 %). The difference between the US and CEUS was statistically significant (P＜0.001). Comparative analysis of 142 lesions examined with both CEUS and CECT, CEUS showed non-inferior accuracy to CECT (85.2 % [95 % CI: 80.0-90.9 %] vs 81.0 % [95 % CI: 74.7-87.3 %], P = 0.21).

Conclusion: CEUS demonstrates significant promise in the diagnosis of liver solid-cystic lesions. Compared with US, CEUS further enhances diagnostic accuracy and is not inferior to CECT in our study.

Keywords: Contrast-enhanced ultrasound; Diagnosis; Lesion; Liver; Solid-cystic; Ultrasound.