Ming Xu1, Fu-Shun Pan2, Wei Wang2, Xiao-Er Zhang2, Xiao-Ju Li2, Yu Hong3, Lu-Yao Zhou2, Xiao-Yan Xie4, Ming-de Lyu5. 1. Department of Medical Ultrasonics, the First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 2. Department of Medical Ultrasonics, the First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China. 3. University of Texas at Dallas, Richardson, TX, USA. 4. Department of Medical Ultrasonics, the First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China. Electronic address: xiexyan@mail.sysu.edu.cn. 5. Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Abstract
OBJECTIVES: To investigate the combined use of ultrasound together with clinical features to differentiate infantile hepatic hemangioma (IHH) from other focal liver lesions (FLLs) in children and to compare the efficacy of the combined method to that of CECT/MRI. METHODS: The location, number, size and appearance of the tumors were evaluated in 45 children with IHH. Another 45 children with FLL were randomly selected as a control group. Independent factors for predicting IHH versus FLLs were evaluated. The diagnostic performance of the clinical and ultrasound features was compared with CECT/MRI. RESULTS: Compared with the control FLL group, the IHH group had a younger age at diagnosis (P = 0.008), lower alpha-fetoprotein (AFP) levels (P = 0.000), smaller lesion sizes (P = 0.000), and a higher tumor proportion with a resistance index (RI) of <0.7. Multiple logistic regression analysis showed that age, size, RI and AFP were independent factors for predicting IHH. Receiver operating characteristic (ROC) curve analysis showed that the AUC (area under the curve) of the four combined independent factors was 0.881 (95% CI: 0.744-0.960), while the AUC for the CECT/MRI method was 0.905 (95% CI: 0.774-0.973), and the combined AUC for the independent factors and CECT/MRI was 0.929 (95% CI: 0.805-0.985). There were not statistically significant among the three AUCs (P > 0.05). CONCLUSIONS: CECT/MRI was the effective diagnostic indicator for IHH. However, the combined clinical and ultrasound diagnoses, including age at diagnosis, lesion size, RI and AFP, can achieve the same effectiveness as CECT/MRI.
OBJECTIVES: To investigate the combined use of ultrasound together with clinical features to differentiate infantile hepatic hemangioma (IHH) from other focal liver lesions (FLLs) in children and to compare the efficacy of the combined method to that of CECT/MRI. METHODS: The location, number, size and appearance of the tumors were evaluated in 45 children with IHH. Another 45 children with FLL were randomly selected as a control group. Independent factors for predicting IHH versus FLLs were evaluated. The diagnostic performance of the clinical and ultrasound features was compared with CECT/MRI. RESULTS: Compared with the control FLL group, the IHH group had a younger age at diagnosis (P = 0.008), lower alpha-fetoprotein (AFP) levels (P = 0.000), smaller lesion sizes (P = 0.000), and a higher tumor proportion with a resistance index (RI) of <0.7. Multiple logistic regression analysis showed that age, size, RI and AFP were independent factors for predicting IHH. Receiver operating characteristic (ROC) curve analysis showed that the AUC (area under the curve) of the four combined independent factors was 0.881 (95% CI: 0.744-0.960), while the AUC for the CECT/MRI method was 0.905 (95% CI: 0.774-0.973), and the combined AUC for the independent factors and CECT/MRI was 0.929 (95% CI: 0.805-0.985). There were not statistically significant among the three AUCs (P > 0.05). CONCLUSIONS: CECT/MRI was the effective diagnostic indicator for IHH. However, the combined clinical and ultrasound diagnoses, including age at diagnosis, lesion size, RI and AFP, can achieve the same effectiveness as CECT/MRI.
Authors: Cheng Fang; Sudha A Anupindi; Susan J Back; Doris Franke; Thomas G Green; Zoltan Harkanyi; Jörg Jüngert; Jeannie K Kwon; Harriet J Paltiel; Judy H Squires; Vassil N Zefov; M Beth McCarville Journal: Pediatr Radiol Date: 2021-05-12