| 吕珂,姜玉新,戴晴,谭莉,朱庆莉,夏宇,孟华,齐振红,高嫔.超声造影对肝脏局灶性病变的诊断价值[J].中国医学影像技术,2007,23(10):1527~1530 |
| 超声造影对肝脏局灶性病变的诊断价值 |
| Value of contrast-enhanced ultrasound for diagnosis of focal liver lesions LV Ke, JIANG Yu-xin*, DAI Qing, Tan Li, |
| 投稿时间：2007-03-09 修订日期：2007-07-15 |
| DOI： |
| 中文关键词: 肝脏 肝局灶性病变 超声检查 造影剂 |
| 英文关键词:Liver Focal liver lesion Ultrasonography Contrast media |
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| 中文摘要: |
| 目的 评价超声造影对肝脏局灶性病变的诊断与鉴别诊断价值。方法 对103个肝脏局灶性病变的常规超声及超声造影特征进行前瞻性研究,采用5分评分法进行良、恶性诊断及ROC曲线分析,比较超声造影前后肝脏局灶性病变的鉴别诊断价值。结果 98.2％恶性病灶(56/57)超声造影动脉相表现为弥漫或环状增强,诊断敏感性98.2％,特异性82.6％;延迟相,82.5％(47/57)恶性病灶增强信号廓清,诊断敏感性82.5％,特异性84.8％。良性病灶中17.4％(8/46)动脉相弥漫增强;84.8％(39/46)延迟相持续增强。血管瘤呈向心性增强,诊断敏感性81.8％,特异性100％。局灶性结节性增生动脉相放射状增强,诊断敏感性66.7％,特异性99.0％。根据诊断评分,超声造影诊断肝脏良恶性病变的敏感性为98.2％,特异性为91.3％,高于常规超声诊断;其ROC曲线下面积(0.948)大于常规超声诊断者(0.811, P＝0.000)。结论 超声造影肝局灶性良恶性病变具有特征性表现,其诊断应用价值高于常规超声。 |
| 英文摘要: |
| Objective To assess the value of contrast-enhanced ultrasound to reveal differences between the benign and malignant focal liver lesions. Methods One hundred and three focal liver lesions were prospectively evaluated with real-time harmonic ultrasonographic imaging. A diagnostic score of 1 to 5 was given to each lesion before and after contrast injection and the diagnosis value was compared with ROC curve for differentiation between the benign and malignant focal liver lesions. Results Fifty-six of the 57 malignant liver lesions had diffuse or ring-like contrast enhancement in the arterial phase and it had sensitivity of 98.2%, specificity of 82.6%. Forty-seven of the 57 malignant lesions had demarcation enhancement appeared as hypoechoic lesion in the late phase and it had sensitivity of 82.5%, specificity of 84.8%. Centripetal fill-in enhancement from periphery enhancement as a sign of hemangioma had sensitivity of 81.8% and specificity of 100%. Early central star-like arterial enhancement as a sign of FNH had sensitivity of 66.7% and specificity of 99.0%. For differentiation of malignant and benign focal liver lesions, contrast-enhanced ultrasound had sensitivity of 98.2%, specificity of 91.3%, and had higher diagnostic value than conventional ultrasound. Receiver operating characteristic analysis revealed a significant improvement in this discrimination (area under the receiver operating characteristic curve, 0.811 at conventional ultrasound, 0.948 at contrast-enhanced ultrasound, P=0.000). Conclusion Contrast-enhancement ultrasound has characteristics for the benign and malignant focal liver lesions and greater value of clinical usefulness than conventional ultrasound. |
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