相对造影参数在胰腺原发良恶性病灶鉴别诊断中的应用价值

Value of relative contrast-enhanced ultrasound parameters in differential diagnosis of primary benign and malignant pancreatic lesions

目的通过对胰腺肿瘤超声造影量化分析,探讨相对造影参数在胰腺原发良恶性病灶鉴别诊断中的应用价值。方法应用SonoLiver超声造影定量分析系统获取时间-强度曲线和多个定量参数,比较各相对造影参数在胰腺原发良恶性病变之间的差异。结果用低增强模式诊断胰腺原发恶性病变的敏感性为100%,特异性为73.68%,阳性预测值为90.91%,阴性预测值为100%,准确性为92.75%;用晚增强模式诊断胰腺原发恶性病变的敏感性为80.00%,特异性为84.21%,阳性预测值为93.02%,阴性预测值为61.54%,准确性为81.16%。相对平均渡越时间、相对上升时间及相对峰值强度在良恶性病灶间比较差异有统计学意义(P﹤0.05);相对达峰时间和相对到达时间在良恶性病灶间比较差异无统计学意义。结论超声造影能够提供更多的血流灌注特征,为胰腺原发占位性病变的诊断及鉴别诊断提供参考依据,有重要的临床应用价值。

Objective To evaluate the application value of relative contrast-enhanced ultrasound （CEUS） parameters in the differential diagnosis of primary benign and malignant pancreatic lesions by analyzing quantitatively microcirculation of pancreatic turners.Methods The time-intensity curves and quantitative parameters were obtained using SonoLiver analysis system of contrast-enhanced ultrasound.The relative CEUS parameters were compared in primary benign and malignant pancreatic lesions.Results Using hypo-enhancement as a diagnosis indicator for primary malignant pancreatic lesions,the sensitivity, specificity,positive predictive value,negative predictive value and accuracy were 100%,73.68% ,90.91%, 100%and 92.75%, respectively.Using late-in perfusion mode as a diagnosis indicator for primary malignant pancreatic lesions,the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 80.00%, 84.21%, 93.02%, 61.54% and 81.16%, respectively.There were significant differences in relative mean transit time, relative rise time and relative peak intensity between malignant and benign pancreatic lesions （P 〈 0.05 ）.There were no significant differences in relative time to peak and relative arrival time between malignant and benign pancreatic lesions.Conclusion CEUS can provide more blood flow perfusion characteristics and provide a reference basis for the diagnosis and differential diagnosis of primary benign and malignant pancreatic lesions, which has important clinical application value.