超声造影对胰腺假性囊肿、囊腺瘤及囊腺癌鉴别诊断的价值

The application of contrast-enhanced ultrasound in the differential diagnosis between pancreatic pseudocysts,cystadenomas and cystadenocarcinomas

目的探讨超声造影鉴别诊断胰腺假性囊肿、囊腺瘤及囊腺癌的价值。方法回顾性分析2005年2月至2010年8月在我院接受常规超声和超声造影检查的31例胰腺囊性病变患者的临床资料,总结其常规超声和超声造影的图像特点,比较两者在胰腺囊性病变诊断中的价值。结果共发现32个病灶,其中胰腺假性囊肿18个,胰腺囊腺瘤9个,胰腺囊腺癌5个。常规超声及超声造影对胰腺囊性病变的诊断正确率分别为50.0%(16/32)、75.0%(24/32),其差异具有统计学意义(P=0.039)。超声造影在胰腺囊性病变中对胰腺假性囊肿诊断价值最高(Youden指数最高),与本研究诊断标准比较其诊断一致性符合率也最好(Kappa值为0.814)。结论与常规超声比较,超声造影能显著提高胰腺囊性病变的诊断准确率。

Objective To evaluate the clinic value of contrast-enhanced ultrasound（CEUS） in the diagnosis of pancreatic pseudocysts,cystadenomas and cystadenocarcinomas.Methods A total of fifty-three subjects with pancreatic cystic disease were retrospectively analysed and examined in our hospital.Thirty-one cases were chosen to analyse the image feature of baseline ultrasound（BUS） and CEUS.Then their values of diagnosis in pancreatic cystic disease were compared.Results Of the 32 lesions,eighteen was pseudocysts,nine was cystadenomas,and five was cystadenocarcinomas.The diagnostic accuracy of CEUS in pancreatic cystic lesions was 75.0%（24/32）,which was significantly different from that of BUS（50.0%,16/32,P=0.039）.CEUS had the best diagnostic value for the pancreatic pseudocysts（the highest Youden index）,and the best diagnostic agreement（Kappa statistics is 0.814）.Conclusion Compared with BUS,CEUS can significantly improve the differential diagnosis of pancreatic cystic lesions.