肝外伤的超声造影分级及与CT、手术结果对照研究

Preliminary study of contrast-enhanced ultrasound grading in hepatic trauma：compared with CT and operative results

目的探讨肝外伤的超声造影分级。方法对45例肝外伤患者行超声造影检查,其中21例行手术探查,32例行CT检查,超声造影分级结果分别与手术、CT进行对照。结果与手术结果对照,超声造影分级符合率为95.2%（20/21）,与CT对照符合率为87.5%（28/32）。结论肝外伤超声分级与CT、手术探查范围对应性好,可以较准确地反映肝损伤程度并指导治疗方案的选择。

Objective To evaluate hepatic trauma grading with contrast-enhanced ultrasound compared with CT and operation results.Methods Forty-five patients with proved blunt hepatic injuries underwent contrast-enhanced ultrasound （CEUS） before treatment.The injuries were classified with a five-point CEUS-based grading system.The CEUS injury grades were compared with CT,surgical finding and the follow-up results.Results Twenty-one patients with hepatic injury were performed surgical operation.The accuracy rate of the CEUS liver injury grading compared with operative results was 95.2%（20/21）,which had good grading concordance （Kappa value=0.929,P=0.000）.CT examinations were performed in 32 cases.The accuracy rate of CEUS and CT grades was 87.5%（28/32）,which had good grading concordance （Kappa value =0.900,P=0.000）.ConclusionsHepatic trauma grade with CEUS may accurately reflect the degree of hepatic parenchymal damage.It is helpful in deciding whether surgical operation is necessary.Monitoring nonoperative management with CEUS allows detection of resultant complication.