Diagnostic value of time-intensity curve for hepatic space-occupying lesions

Objective To analyze the diagnostic values of contrast- enhanced ultrasound (CEUS) and time- intensity curve (TIC) for alpha- fetoprotein (AFP) - negative hepatocellular carcinoma ( HCC) , AFP- positive HCC, and hepatic hemangioma. Methods Patients with a confirmed diagnosis from October 2012 to October 2013 were divided into AFP- negative HCC group (24 patients) , APP- positive HCC group (48 patients) , and hepatic hemangioma group (76 patients) . Routine ultrasound, CEUS, and TIC analysis were performed on the three groups. CEUS findings and TIC indices of the three groups were compared using χ2test and independent- samples t test, respectively. Results There were significant differences in the CEUS findings during arterial and parenchymal phases between the AFP- negative HCC group and hemangioma group (χ2= 39. 4, P = 0. 001; χ2= 78. 9, P = 0. 001) , as well as between the AFP- positive HCC group and hemangioma group (χ2= 50. 6, P = 0. 001; χ2= 89. 7, P = 0. 001) , but no significant differences were observed in the CEUS findings during the same two phases between the AFP- negative HCC and AFP- positive HCC group (χ2= 0. 036, P = 0. 85; χ2= 0. 22, P = 0. 643) .The time to peak (TP) , peak intensity, area under the ROC curve (AUC) , and mean transit time (MTT) for the AFP- negative HCC group were 27. 52 ± 4. 11 s, 49. 52% ± 4. 31%, 1527. 20 ± 80. 37% s, and 78. 71 ± 3. 26 s, respectively, versus 28. 28 ± 4. 09 s, 50. 20% ± 4. 37%, 1725. 08 ± 78. 46% s, and 79. 21 ± 3. 32 s, respectively, for the AFP- positive HCC group, as well as 50. 42 ± 5. 32 s, 47. 83% ± 4. 29%, 1613. 44 ± 76. 37% s, and 79. 86 ± 3. 10 s, respectively, for the hemangioma group; there were significant ofifferences in TP among the three groups (F = 568. 63, P = 0. 001) , there were no significant differences in peak intensity, AUC and MTT among the three groups ( F =0. 245, 0. 645, 0. 860, P > 0. 05) . there were significant differences in TP between the AFP- negative HCC group and hemangioma group (P= 0. 001) , as well as between the AFP- positive HCC group and hemangioma group (P =0. 001) , but no significant difference in TP was observed between the AFP- negative HCC group and AFP- positive HCC group. Conclusion AFP- negative HCC ( or AFP- positive HCC) and hepatic hemangioma can be diagnosed differentially by CEUS findings and TP. A combination of the two examinations can improve the diagnostic value for benign and malignant liver lesions and increase the detection rate of AFP- negative HCC.