Ultrasound Clinical Trial
Official title:
Contrast-enhanced Ultrasound in Liver Tumor by Sonazoid
Sonazoid as a new generation of ultrasound contrast agent.This study based on the features of Sonazoid specific angiography and his mechanical index, the role of Sonazoidin in the differential diagnosis of benign and malignant focal liver lesions in different liver background was explored
Sonazoid as a new generation of ultrasound contrast agent, was liver specificity (Kupffer
cells), macrophages at the very stable period, Kupffer imaging contrast enhancement effect
for more than 1 hour, it is mainly used for focal liver lesions of blood vessels and Kupffer
phase of ultrasonic imaging, facilitate early detection of small lesions (< 1 cm). Until now,
Sonazoid has been mainly focused on liver focal lesions.
Most liver cancer patients in China are associated with chronic liver disease, and more than
80% of liver disease patients are in advanced stage at the time of treatment. Differential
diagnosis is still a challenge for enhanced CT / MRI. About 40% of HCCs lack arterial phase
enhancement and 40% - 60% of small lesions do not show elution in venous phase. The existing
imaging methods have low sensitivity in detecting small lesions, and it is difficult to
detect lesions smaller than 1 cm. Studies have found that the sensitivity of CT and MRI is of
60 - 94.4% and 58.5 - 93% respectively when the tumor diameter is larger than 1 cm. When the
tumor diameter is less than 1 cm, the sensitivity of CT and MRI to detect tumors is reduced
to 33 - 45% and 33 - 67%, respectively. The diagnostic efficiency of conventional
ultrasonography for small lesions, especially in patients with chronic hepatitis B or
cirrhosis, is poor. Although the diagnostic efficiency of conventional contrast-enhanced
ultrasound in the diagnosis of small lesions with chronic hepatitis B or liver cirrhosis has
a certain improvement, there is still a large rate of missed diagnosis. In addition, ordinary
ultrasound, conventional contrast-enhanced ultrasound, CT and MRI are very poor in the
diagnosis of liver cancer differentiation, especially for highly differentiated liver cancer.
Sonazoid is a second generation ultrasound contrast agent, which is composed of microbubbles
containing chemically stable and insoluble Perfluorobutane (PFB) gas and a hard shell of
phosphatidylserine sodium (2-3 μ m in diameter) wrapped in the outer layer. These
microbubbles can generate stable nonlinear oscillations in a low-power acoustic field and
generate echoes at the second harmonic frequency of the transmitted pulse for enhanced
contrast harmonic imaging . In addition to the ability of real-time angiography, Sonazoid
microbubbles can be engulfed by Kupffer cells in the intrahepatic reticuloendothelial system
to produce liver parenchymal imaging Usually 10 minutes after intravenous injection of
Sonazoid contrast agent, Kupffer phase image appears, and normal liver parenchyma is enhanced
. Therefore, at this stage, malignant lesions with little or no Kupffer cells are clearly
demonstrated due to the lack of contrast media. In addition, because Sonazoid microbubbles
can resonate without rupture under moderate ultrasonic pressure, Kupffer phase (Kupffer
phase) imaging can be stable for more than several hours, which is beneficial to whole liver
scanning . Because Sonazoid has the advantages of ultra long time development and good
stability, Sonazoid has significant clinical advantages in the diagnosis of small liver
cancer lesions, liver cirrhosis background liver cancer and highly differentiated liver
cancer.. However, these studies based on Sonazoid are all small sample studies and subjective
qualitative differential diagnosis methods, and lack of systematic analysis and research.
Therefore, based on the advantages of the new ultrasound contrast agent, using qualitative
analysis and quantitative analysis method to collect large samples, systematically explore
the standardized diagnosis scheme and diagnostic efficiency of liver cancer with different
liver background, which has important clinical significance for early diagnosis, early
detection and improving the accuracy of diagnosis of liver cancer.
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