超声造影在肝脏局灶性病变定性诊断中的应用

Qualitative diagnosis of focal liver lesions with contrast-enhanced ultrasound

目的探讨超声造影技术对肝脏局灶性病变(FLL)的定性诊断价值。方法采用造影剂SonoVue和实时超声造影匹配成像技术,对86例FLL行超声造影检查,并分析其造影增强表现。结果恶性FLL开始增强时间(12.5±2.2)S明显比良性FLL(15.4±2.8)S早(P<0.05)。54个(96.4%)恶性病灶动脉期呈现不同程度的增强,至延迟期消退为低增强,而27个(90.0%)良性病灶则为动脉期增强后,延迟期持续高或等增强。以延迟期消退呈低增强判定为恶性病变,则本组超声造影诊断恶性FLL的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为96.4%(54/56)、90.0%(27/30)、94.7%(54/57)、93.1%(27/29)、94.2%(81/86)。结论超声造影对提高FLL的定性诊断具有实用价值。

Objective To investigate qualitative diagnostic value of contrast-enhanced ultrasound（CEUS） technique of focal liver lesions （FLL）.Methods CEUS was performed in 86patients with FLLS.Contrast agent SonoVue and contrast tuned imaging technology were used.Contrast-enhanced sonographic features of FLL were analyzed.Results Initaial enhancement time of malignant FLLs （12.5±2.2）s was significantly lower than that of benign FLLs（15.4±2.8）s,（P0.05）.54（96.4%） malignant lesions presented enhancement in arterial phase and hypo-enhancement in late phase,where as 27（90.0%）benign lesions showed enhancement in arterial phase and persistent hyper-oriso-enhancement until late phase.The malignant lesion was estimated by a given criterion of presenting low-enhancement in late phase,the sensitivity,specificity,positive and negative predictive values and accuracy with CEUS in the diagnosis of FLLs were 96.4%（ 54/56 ）,90.0%（ 27/30 ）,94.7% （ 54/57 ） ,93.1% （ 27/29 ） and 94.2% （ 81/86 ）,respectively.Conclusion CEUS is a useful technique in the qualitative diagnosis of FLL.