脉冲反向谐波实时超声造影对肝占位病变良恶性的鉴别诊断

Real-time pulse-inversion sonography using contrast agent: differentiation between benign and malignant focal liver lesions

目的探讨低机械指数实时超声造影鉴别肝占位病变良恶性的临床应用价值。方法采用静脉团注造影剂SonoVue和低机械指数脉冲反向谐波技术对192例肝占位病变(109例恶性肿瘤,83例良性病变)进行实时灰阶超声造影,将造影前后病灶评分与病理结果进行比较分析。结果超声造影前肝脏恶性肿瘤诊断的敏感性、特异性和准确性分别为52.3%、44.6.%和49.0%,造影后分别提高到89.0%、96.4%和92.2%(P<0.01)。结论低机械指数实时超声造影可明显增强对肝占位病变良恶性的鉴别诊断能力。

Objective To assess the ability of low mechanical index real-time pulse-inversion sonography in revealing differences between benign and malignant focal hepatic lesions. Methods One hundred and ninety-two patients with focal hepatic lesions （109 malignant lesions and 83 benign lesions） detected by B-mode sonography were examined by using low mechanical index real-time pulse-inversion sonography after contrast agent SonoVue injection. The rating scores （5-point system）, sensitivity, specificity and accuracy were calculated by considering histological analysis. Results Contrast agent SonoVue enhanced real-time sonography improved the sensitivity from 52.3% to 89.0%, the specificity from 44.6% to 96.4% and the accuracy from 49.0% to 92.2% compared with baseline sonograpy （P〈0. 01）. Conclusion Low mechanical index real-time pulse-inversion sonography led to improving the differentiation of benign and malignant liver lesions significantly.