低机械指数实时超声造影对增强CT漏诊肝细胞癌的诊断价值

Diagnostic value of real-time contrast-enhanced ultrasound with low mechanical index in hepatocellular carcinoma misdiagnosed by contrast-enhanced

目的探讨低机械指数实时超声造影对增强CT漏诊肝细胞癌的诊断价值。方法对增强螺旋CT漏诊的32例肝细胞癌患者术前进行低机械指数实时超声造影，并与手术或穿刺活检病理结果比较，评估其诊断价值。结果增强螺旋CT漏诊的32例肝细胞癌患者中，29例超声测量病灶直径≤2cm，彩色多普勒超声确诊13例，低机械指数实时超声造影确诊28例（P〈0．01）。结论低机械指数脉冲反向谐波实时超声造影对增强螺旋CT漏诊肝细胞癌有较高的诊断准确性，具有独立诊断价值，对于增强螺旋CT扫描阴性的病例，具有重要的临床应用价值。

Objective To explore the value of real-time contrast-enhanced ultrasound with low mechanical index in diagnosing hepatocellular carcinoma misdiagnosed by contrast-enhanced CT. Methods Thirty-two patients with hepatocellular carcinoma misdiagnosed by contrast-enhanced CT were performed with real-time contrast-enhanced ultrasound with low mechanical index （ MI 〈 0.19 ） before operation. The diagnostic value was evaluated by comparing its outcome with operation or pathological results of biopsy. Results Of all, the nodule size was less than 2 cm in 29 patients. The diagnostic accuracy of color Doppler uhrasonography and real-time contrastenhanced ultrasound with low mechanical index was 40.6% （13/32） and 87.5% （28/32） , respectively （ P 〈 0.01 ）. Conclusions Real-time contrast-enhanced ultrasound with low mechanical index is a better diagnostic method in detection and characterization of hepatocellular carcinoma misdiagnosed by contrast-enhanced CT. It is especially valuable for patients with negative results of contrast-enhanced CT scan.