摘要
目的:进一步研究超声造影在肝脏局灶性病变良恶性鉴别诊断中的价值.方法:选取肝局灶性病变患者262例为研究对象,行常规超声和超声造影检查,并与病理结果做对比.结果:常规超声及超声造影诊断肝脏局灶性病变良恶性的敏感性、特异性、阳性预测值、阴性预测值、诊断符合率分别为88.8%、75.2%、76.6%、88.0%、81.7%及99.2%、98.5%、98.4%、99.3%、98.8%,二者比较差异有统计学意义(P<0.05).超声造影与病理诊断一致性较好(Kappa=0.976).结论:超声造影提高了对肝脏局灶性病变的定性诊断能力,具有重要临床价值.
AIM: To assess the clinical value of contrastenhanced ultrasound(CEUS) in the differentiation of benign and malignant focal liver lesions. METHOD S : Two hundred and sixty- two patients with focal liver lesions were examined by conventional ultrasound and CEUS. Imaging findings were compared with pathology results. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of conventional ultrasound in the diagnosis of benign and malignant focal liver lesions were 88.8%, 75.2%, 76.6%, 88.0% and 81.7%, respectively, and the corresponding values for CEUS were 99.2%, 98.5%, 98.4%, 99.3% and 98.8%, respectively. There was a statistical difference for each indexbetween the two methods(P < 0.05 for all). CEUS had good consistency with pathological examination in the diagnosis of benign and malignant focal liver lesions. CONCLUSION: Contrast-enhanced ultrasound is of high clinical value in qualitative diagnosis of focal liver lesions.
引文
1 徐金锋,吴瑛,熊奕,彭启慧,董发进,谢明星.超声造影对肝脏实质性小病灶的早期诊断价值.华中科技大学学报(医学版)2008;37:266-269
2 Claudon M,Cosgrove D,Albrecht T,Bolondi L,Bosio M,Calliada F,Correas JM,Darge K,Dietrich C,D'Onofrio M,Evans DH,Filice C,Greiner L,Jger K,Jong Nd,Leen E,Lencioni R,Lindsell D,Martegani A,Meairs S,Nolse C,Piscaglia F,Ricci P,Seidel G,Skjoldbye B,Solbiati L,Thorelius L,Tranquart F,Weskott HP,Whittingham T.Guidelines and good clinical practice recommendations for contrast e n h a n c e d u l t r a s o u n d(C E U S)-u p d a t e 2 0 0 8.Ultraschall Med 2008;29:28-44[PMID:18270887DOI:10.1055/s-2007-963785]
3 李锐,郭燕丽,何芸,张晓航,丁俊,陈朝晖.脉冲反向谐波实时超声造影对肝占位性病变良恶性的鉴别诊断.中国医学影像技术2006;22:186-188
4 Beaton C,Cochlin D,Kumar N.Contrast enhanced ultrasound should be the initial radiological investigation to characterise focal liver lesions.Eur J Surg Oncol 2010;36:43-46[PMID:19709846 DOI:10 .1016/j.ejso.2009.07.187]
5 Xu HX,Xie XY,Lu MD,Liu GJ,Xu ZF,Zheng YL,Liang JY,Chen LD.Contrast-enhanced sonography in the diagnosis of small hepatocellular carcinoma 6 Sporea I,Badea R,Martie A,Sirli R,Socaciu M,Popescu A,DnilM.Contrast enhanced ultrasound for the characterization of focal liver lesions.Med Ultrason 2011;13:38-44[PMID:21390342]
7 Sporea I,Badea R,Martie A,Dumitru E,Ioaniescu S,irli R,Socaciu M,Popescu A,DnilM,Voiculescu M.Contrast Enhanced Ultrasound for the evaluation of focal liver lesions in daily practice.A multicentre study.Med Ultrason 2012;14:95-100[PMID:22675708]
8 周元媛,张瑞芳,秦石成.超声造影对肝脏瘤样病变的诊断及鉴别诊断.中国医学影像技术2009;25:823-825
9 刘利平,董宝玮,于晓玲,刘吉斌,康春松.常规超声与超声造影对肝局灶性病变定性诊断的比较研究.中华超声影像学杂志2007;16:821
10 吕明德,徐辉雄,刘广健,徐作峰,谢晓燕,郑艳玲,梁瑾瑜.应用低机械指数连续超声造影鉴别诊断肝脏局灶性病变.中国超声医学杂志2005;21:440-443
11 荣雪余,冀鸿涛,朱强,肖萍,王振常.超声造影在肝局灶性病变鉴别诊断中的应用.中国医学影像技术2008;24:402-405
12 刘洪媛,薛莉,宋长悦,刘薇,杨先.超声造影在肝脏局灶性病变的诊断价值.中国医疗设备2013;28:171-173
13 张春莉,陈文卫,柏刚,陈辽,黄慧.动态血管模式在肝局灶性病变超声造影鉴别诊断中的应用价值.中华超声影像学杂志2013;22:226-230
14 周悦,高剑波,郭华,万娅敏,张瑞芳,潘元威.实时超声造影技术对VX2兔肝癌影像学模型的诊断价值.世界华人消化杂志2011;19:472-476
15 马琳,卢强,凌文武,周翔,林玲,时莹瑜,罗燕.不同大小的肝细胞癌超声造影特点.世界华人消化杂志2012;20:200-204
16 Sporea I,Martie A,Bota S,Sirli R,Popescu A,Dnila M.Characterization of focal liver lesions using contrast enhanced ultrasound as a first line method:a large monocentric experience.J Gastrointestin Liver Dis 2014;23:57-63[PMID:24689098]
