High Frame Rate Contrast-enhanced Ultrasound Helps Differentiate Malignant and Benign Focal Liver Le

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Background and Aims: This study aimed to evaluate the diagnostic performance of high frame rate contrast-en-hanced ultrasound (H-CEUS) of focal liver lesions (FLLs). Methods: From July 2017 to June 2019, conventional con-trast-enhanced ultrasound (C-CEUS) and H-CEUS were per-formed in 78 patients with 78 nodules. The characteristics of C-CEUS and H-CEUS in malignant and benign groups and the differences between different lesion sizes (1–3 cm, 3–5 cm, or >5 cm) of C-CEUS and H-CEUS were examined. The diagnostic performance of C-CEUS and H-CEUS was ana-lyzed. The chi-square test or Fisher\'s exact test was used to assess inter-group differences. The receiver operating characteristic curve was plotted to determine the diagnostic performance of C-CEUS and H-CEUS. Results: There were significant differences in the enhancement area, fill-in direc-tion and vascular architecture between C-CEUS and H-CEUS for both benign and malignant lesions (all p=0.000–0.008), but there were no significant differences in washout results (p=0.566 and p=0.684, respectively). For lesions 1–3 cm in size, the enhancement area, fill-in direction, and vascular architecture on C-CEUS and H-CEUS were significantly dif-ferent (all p=0.000), unlike for lesions 3–5 cm or >5 cm in size. For differentiation of malignant from benign FLLs in the 1–3 cm group, H-CEUS showed sensitivity, specific-ity, accuracy, and positive and negative predictive values of 92.86%, 95.0%, 96.3%, 90.48% and 93.75%, respectively, which were higher than those for C-CEUS (75.0%, 70.0%, 77.78%, 66.67% and 72.91%, respectively). Conclusions: H-CEUS provided more vascular information which could help differentiate malignant from benign FLLs, especially for lesions 1–3 cm in size.
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