| 王燕,王文平,丁红,黄备建,毛枫,徐智章.多普勒阻力指数在小肝癌定性诊断中的价值[J].中国医学影像技术,2003,19(1):63~66 |
| 多普勒阻力指数在小肝癌定性诊断中的价值 |
| Evaluation of the Resistance Index in Differential Diagnosis of Small Liver Neoplasms by Color Doppler Ultrasonography |
| 投稿时间：2002-09-01 |
| DOI： |
| 中文关键词: 肝肿瘤 彩色多普勒超声 阻力指数 |
| 英文关键词:Liver neoplasms Color Doppler ultrasonography Resistance index |
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| 中文摘要: |
| 目的 探讨多普勒阻力指数(RI)在小肝癌定性诊断中的应用价值。方法 本文对297例共304个肿块直径<30mm的肝脏实质占位进行了彩色多普勒超声和脉冲多普勒(PD)频谱分析。其中原发性肝恶性肿瘤218例,转移性肝恶性肿瘤16例,肝血管瘤19例,局灶性结节性增生17例,血管平滑肌脂肪瘤4例,炎性假瘤8例、肝硬化结节9例,肝结核3例,其他良性病变3例。全部病例均经手术和病理证实。结果 肝脏恶性肿瘤的动脉血流检出率高于良性肿瘤,恶性肿瘤动脉血流检出率为88.2%,良性病变者为58.2%,二者有显著性差异(P<0.01)。经多普勒频谱分析,肝脏良、恶性病变的阻力指数(RI)存在显著性差异(P<0.001),原发性恶性肝肿瘤的RI值为0.77±0.12,转移性恶性肝肿瘤的RI值为0.71±0.07,良性病变RI平均值在0.6以下;良、恶性占位的血流阻力不同与病变的病理组织结构有关。结论 如果以彩色多普勒血流显像显示有动脉血流,且RI≥0.6作为诊断肝脏恶性肿瘤的标准,则敏感性为96.2%,特异性为88.1%,准确性为94.2%。因此,RI有助于小肝癌与良性病变的鉴别,有其临床实用价值。一旦肿瘤内部或周边测及动脉血流,且RI≥0.6,则恶性肿瘤可能性大,如测及静脉血流,或测及动脉血流但RI <0.6,则良性病变可能性大。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of the resistance index (RI) in color Doppler ultrasonography for small liver neoplasms. Methods Two hundred and ninty-seven patients with 304 hepatic solid lesions which had a diameter smaller than 30mm were studied with color Doppler flow imaging (CDFI) and pulsed Doppler,including 234 malignant cases (218 primary malignant liver tumors,and 16 metastatic liver tumors ),67 benign lesions.All of them were confirmed by operation and pathology. Results The detection rate of arterial flow in malignant tumors was 88.2%,while it was 58.2% in benign lesions,which was significantly different.With Doppler spectrum analysis,resistance index in primary malignant tumors was 0.77±0.12,in metastatic tumors that was 0.71±0.07,whereas the average RI in benign lesions was below 0.6.The difference was significant.This difference was correlated with tissue structure of histopathology. Conclusion If arterial flow was detected with CDFI,RI≥0.6 was regarded as a criterion of the malignant tumor,the sensitivity was 96.2%,specificity was 88.1%,accuracy was 94.2% while RI＜0.6,was regarded as an index of benign disorders of liver. |
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