Multi-parameter ultrasound based on the logistic regression model in the differential diagnosis of hepatocellular adenoma and focal nodular hyperplasia

Table 1 Comparison of clinical data between hepatocellular adenoma group and focal nodular hyperplasia group

	HCA group, n = 31	FNH group, n = 50	t/χ2 value	P value
Age	27.29 ± 9.87	28.09 ± 10.57	0.339	0.735
Gender, male/female	8/23	24/26	3.994	0.047
History of viral infection	6%	9%	0.023	0.879
History of cirrhosis	4%	6%	0.014	0.904
ALT, U/L	24.83 ± 12.94	28.76 ± 15.38	1.185	0.239
AST, U/L	29.83 ± 12.85	26.92 ± 13.64	0.954	0.343
GGT, U/L	38.32 ± 14.08	30.84 ± 10.36	1.529	0.183
Albumin, g/L	48.23 ± 3.82	47.93 ± 3.58	0.482	0.528
Tbil, μmol/L	9.38 ± 4.83	10.63 ± 5.63	0.392	0.682
PT, s	12.86 ± 0.86	12.67 ± 0.74	1.055	0.295
AFP, μg/L	14.05 ± 5.97	12.39 ± 4.29	1.454	0.150
SF, μg/L	89.35 ± 35.24	96.32 ± 43.2	0.755	0.452

HCA: Hepatocellular adenoma; FNH: Focal nodular hyperplasia; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Glutamyl transpeptidase; Tbil: Total bilirubin; PT: Prothrombin time; AFP: Alpha-fetoprotein; SF: Serum ferritin.

Table 2 Comparison of ultrasound characteristics between hepatocellular adenoma group and focal nodular hyperplasia group

		HCA group, n = 31	FNH group, n = 50	t/χ2 value	P value
Diameter in cm		3.37 ± 1.87	3.29 ± 1.58	0.206	0.837
Lesion location	Liver right lobe	24	36	0.293	0.589
	Liver left lobe	7	14
Lesion echo	Low	9	31	11.637	0.009
	Equal	5	9
	High	14	10
	Mixed	2	0
Lesion property	Solid	18	16	6.202	0.045
	Cystic	9	23
	Mixed	3	11
Lesion morphology	Regular	27	44	0.014	0.904
	Irregular	4	6
Lesion boundary	Clear	27	47	1.155	0.282
	Unclear	4	3
Lesion capsule	With capsule	30	46	0.753	0.386
	Without capsule	1	4
Lesion internal echo	Uniform	26	43	0.069	0.793
	Non-uniform	5	7
Microcalcification	No	30	48	0.032	0.858
	Yes	1	2
Posterior echo	No echo attenuation	31	48	1.271	0.260
	Echo attenuation	0	2
Lesion blood flow	No blood flow	7	20	4.870	0.088
	Spotted blood flow	18	27
	Strip blood flow	6	3
SWE	YM value in kPa	14.39 ± 7.28	29.27 ± 12.38	6.065	0.000
	YM ratio	3.73 ± 1.14	4.89 ± 1.99	2.770	0.007
TIC Quantitative analysis	PI-BI, dB	21.84 ± 8.83	20.18 ± 9.38	0.791	0.431
	ET, s	18.02 ± 5.88	20.27 ± 8.39	1.306	0.195
	TIC increasing slop	1.84 ± 0.62	1.72 ± 0.23	1.241	0.218
	TIC decreasing slop	0.31 ± 0.09	0.14 ± 0.07	9.510	0.000

HCA: Hepatocellular adenoma; FNH: Focal nodular hyperplasia; YM: Young's modulus; TIC: Time intense curve; ET: Enhancement time; PI-BI: Peak intensity background intensity; SWE: Shear wave elastography

Table 3 Multivariate logistic regression analysis of hepatocellular adenoma identification

	B	SE	Wald	P value	OR	95%CI
						Lower limit	Upper limit
Gender	0.284	0.354	2.394	0.086	1.328	0.664	2.658
Lesion echo	0.977	0.157	7.967	0.000	2.657	1.953	3.614
Lesion property	0.427	0.964	1.234	0.137	1.532	0.232	10.135
YM value	- 0.289	0.108	6.567	0.000	0.749	0.606	0.926
YM ratio	- 0.154	0.135	1.436	0.134	0.857	0.658	1.117
TIC decreasing slope	1.673	0.284	5.829	0.000	5.328	3.054	9.296

YM: Young's modulus; TIC: Time intense curve.

Table 4 ROC curve analysis of multiple ultrasound parameters in the differential diagnosis of hepatocellular adenoma and focal nodular hyperplasia

	AUC	95%CI	Cut-off point	Sensitivity, %	Specificity, %
YM value	0.891a	0.820-0.941	23.26	92.16	73.28
TIC decreasing slope	0.785a	0.700-0.856	0.23	82.47	66.39
Lesion echo	0.676a	0.583-0.759	3	40.35	93.82
Combination	0.938	0.878-0.974	0.540	91.23	83.33

^aP < 0.05. YM: Young's modulus; TIC: Time intense curve.