Quantitative Contrast-Enhanced Ultrasound Characterization of Perilesional Perfusion and Its Association with...

Hepatic alveolar echinococcosis (HAE) is characterized by infiltrative growth and remodeling of perilesional host tissue, including microvascular changes. We investigated whether quantitative contrast-enhanced ultrasound (CEUS) could characterize perilesional perfusion and its animal-level association with CD34-positive cell density in a standardized rat model. Twenty female Sprague Dawley rats underwent ultrasound-guided intrahepatic HAE modeling and CEUS 10 weeks later. Peak enhancement (PE), rise time (RT), time to peak (TTP), wash-in rate (WiR), wash-in perfusion index (WiPI), and wash-in area under the curve (WiAUC) were measured in the perilesional zone and reference liver parenchyma. CD34-positive cell density was quantified by digital pathology. The perilesional zone showed higher PE, WiR, WiPI, and WiAUC and shorter RT and TTP than the reference liver parenchyma (all FDR-adjusted p < 0.001). CD34-positive cell density correlated positively with PE (ρ = 0.696, FDR-adjusted p = 0.004), WiR (ρ = 0.525, FDR-adjusted p = 0.026), WiPI (ρ = 0.614, FDR-adjusted p = 0.012), and WiAUC (ρ = 0.534, FDR-adjusted p = 0.026), but not with RT or TTP. Within this experimental model, these findings indicate increased and accelerated perilesional perfusion and support quantitative CEUS as a contrast-enhanced imaging-based approach for characterizing its relationship with local microvascularity.