三维超声彩色多普勒能量图诊断肝脏肿瘤

Three-dimensional color Doppler energy in the diagnosis of liver tumors

目的探讨三维超声彩色多普勒能量图(3D-CDE)对肝脏恶性肿瘤的定位诊断。方法对96例肝脏肿瘤共计106个病灶的2D-CDE和3D-CDE的血管分型进行分析,分别计算其敏感性和特异性;用三维容积测定法计算肿瘤的体积、计数肿瘤的血管条数、计算血管条数与肿瘤的体积之比,分析良、恶性肿瘤的血管指数。结果①2D-CDE和3D-CDE以血管分型Ⅲ型判断肝脏恶性肿瘤的敏感性和特异性分别为21.33%、100%和81.33%、100%;以血管分型Ⅱ型以上判断肝脏恶性肿瘤的敏感性和特异性分别为73.33%、67.74%和100%、45.16%。②75例恶性肿瘤平均血管指数(VI)为0.38条/cm3;31个良性肿瘤平均VI为0.18条/cm3,二者差异有统计学意义(P<0.05);以VI>0.30条/cm3判断肝脏恶性肿瘤的敏感性为78.67%,特异性为87.10%。结论3D-CDEⅢ型血管分型和VI>0.30条/cm3可以作为诊断肝脏恶性肿瘤的指标。

Objective To assess three-dimensional color Doppler energy（3D-CDE） in the diagnosis of liver tumors.Methods Vascular pattern of 2D-and 3D-CDE were used to analyze 106 tumors of 96 patients,and their sensitivity and specify were calculated respectively.Three-dimensional volumetric measurement was used to calculate the volume,vessel counts of tumor,as well as the ratio of vessel counts and volume,whereas vascular index（VI） of both benign and malignant lesions were assessed.Results ①Using the vascular pattern of Ⅲ as diagnosis standard of liver malignant,the sensitivity and specificity of 2D-CDE and 3D-CDE were 21.33%,100% and 81.33%,100%,respectively;using the vascular pattern of Ⅱ and Ⅲ,the sensitivity and specificity were 73.33%,67.74% and 100%,45.16%,respectively.②Mean VI was 0.38 counts/cm3 of malignant tumors and 0.18 counts/cm3 of 31 benign tumors（P〈0.05）,The sensitivity and specificity in diagnosing malignant tumors of liver was 78.67% and 87.10%,respectively with VI〉0.30 counts/cm3.Conclusion The vascular pattern of 3D-CDE Ⅲ and VI〉0.30 counts/cm3 may be taken as parameters for the diagnosis of malignant liver tumor.