Contrast-enhanced ultrasound imaging for intestinal lymphoma

Table 1 B-mode ultrasound and contrast-enhanced ultrasound patterns and clinicopathological characteristics of intestinal lymphoma in 18 patients

No.	Age (yr)	Sex	Location	Pathological subtype	B-mode US pattern	CEUS enhancement pattern	Necrosis
1	78	M	Ileocecal region	DLBCL	Mass type	Diffuse, inhomogeneous, arterial hyperechoic uptake. gradually venous wash-out	Yes
2	34	M	Rectum	MATL	Mass type	Diffuse, inhomogeneous, arterial hyperechoic uptake. gradually venous wash-out	Yes
3	43	M	Mesentery	DLBCL	Mesenteric type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
4	46	M	Small intestine	FL	Mass type	Diffuse, homogeneous, hypoechoic, arterial uptake. gradually venous wash-out	No
5	75	F	Ascending colon	DLBCL	Infiltration type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
6	78	F	Jejunum, ileum	EATL	Mass type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
7	52	F	Jejunum	DLBCL	Mass type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
8	74	M	Small intestine	DLBCL	Mass type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
9	52	M	Jejunum, ileum	MATL	Mass type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
10	61	M	Mesentery	DLBCL	Mesenteric type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
11	41	F	Mesentery	DLBCL	Mesenteric type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
12	46	F	Small intestine	DLBCL	Mass type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
13	64	M	Ileocecum, ascending colon	DLBCL	Mass type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
14	68	F	Small intestine	DLBCL	Mixed type	Diffuse, inhomogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes
15	61	F	Small intestine	FL	Mass type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
16	85	M	Small intestine	MCL	Mass type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
17	35	M	Mesentery	FL	Mesenteric type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	No
18	68	F	Small intestine	DLBCL	Mass type	Diffuse, homogeneous, hyperechoic arterial uptake. gradually venous wash-out	Yes

CEUS: Contrast-enhanced ultrasound; DLBCL: Diffuse large B-cell lymphoma; FL: Follicular lymphoma; MCL: Medial collateral ligament; MATL: Melanoma-associated T-lymphocytes; EATL: Enteropathy associated T-cell lymphoma.

Table 2 Tumor necrosis and tumor size, clinical stage and pathological subtypes

Characteristic	With necrosis	Without necrosis
Tumor size (cm)	8.36	9.58
Stage
Early stage	3	5
Advanced stage	8	2
Subtypea
Indolent subtype	1	4
Aggressive subtype	10	3

^aP = 0.047.

Table 3 Time–intensity curve parameters of contrast-enhanced ultrasound

TIC parameters	Range	mean ± SD
Rise time (s)	2.90-27.62	13.74 ± 6.11
Time to peak (s)	7.64-36.00	24.41 ± 6.61
Mean transit time (s)	29.94-77.75	49.94 ± 13.98
Time from peak to one half (s)	36.38-127.85	77.88 ± 24.12
Peak intensity (dB)	7.8-29.28	17.57 ± 5.98
WIS (dB/s)	0.53-29.28	1.35 ± 1.09
AUC	590.99-3616.03	1772.05 ± 824.89

AUC: Area under curve; WIS: Wash in slope; TIC: Time–intensity curve.

Table 4 Time–intensity curve parameters and serum lactate dehydrogenase level

TIC parameters	Normal LDH	Elevated LDH	P value
Rise time (s)	14.34	12.78	0.693
Time to peak (s)	27.17	27.07	0.982
Mean transit time (s)	53.39	46.21	0.382
Time from peak to one half (s)	82.70	72.49	0.442
Peak intensity (dB)	16.50	16.68	0.955
Wash in slope (dB/s)	1.38	1.26	0.824
Area under the curve (dBs)	1699.47	1712.42	0.979

TIC: Time–intensity curve; LDH: Lactate dehydrogenase.