ROC分析法评价多普勒超声对急性感染性胆囊炎的诊断价值

Value of ROC analysis of Doppler ultrasound in diagnosis of acute infectious cholecystitis

目的探讨彩色多普勒超声对急性感染性胆囊炎的定性诊断价值,为提高急性感染性胆囊炎的定性诊断率提供理论依据。方法对68例急性感染性胆囊炎行腹部彩色多普勒超声检查,评价患者的胆囊形态、超声Murphy征、胆汁透声的好与差及胆囊壁的厚、薄或粗糙程度;利用受试者的工作特征(ROC)曲线评价上述指标对急性感染性胆囊炎的诊断价值。结果急性胆囊炎组胆囊肿大62例、超声Murphy征阳性66例、胆汁透声差57例、胆囊壁厚或粗糙63例,阳性率分别为91.2%、97.1%、83.8%、92.6%,均明显高于非胆囊炎组,差异有统计学意义(P<0.01);将上述4个指标加以综合对急性感染性胆囊炎的诊断正确率为95.0%,灵敏度为95.2%,特异性为94.7%,ROC曲线下面积为0.985。结论多普勒超声能评价急性感染性胆囊炎的胆囊形态、胆囊壁厚或粗糙程度、胆汁透声情况及超声Murphy征,可提高该病定性诊断准确率。

OBJECTIVE To evaluate the qualitative value of color Doppler ultrasound in diagnosis of acute infectious cholecystitis so as to provide a theoretical basis for improving the qualitative diagnosis of acute infectious cholecys- titis. METHODS A total of 68 cases of acute infectious cholecystitis patients underwent the abdominal color Doppler ultrasound. The gallbladder morphology, ultrasound Murphy sign, the good or poor sound for bile, thick or thin or roughness of gallbladder wall were evaluated by the method of Doppler ultrasound% the diagnostic value of the above indicators for the acute infectious cholecystitis was evaluated by receiver operating characteristics （ROC） curves. RESULTS There were 62 cases （91. 2%） with acute cholecystitis gallbladder enlargement, 66 cases （97. 1%） with ultrasound Murphy sign, 57 cases （83. 8%） with the poor sound of bile, and 63 cases （92.6%） with gallbladder wall thickness or roughness, significantly higher than that of the non-cholecystitis group, the difference was statistically significant （P〈0. 001）. The rate of correct diagnosis of acute infectious cholecystitis was 95.0%, with the sensitivity of 95.2%, the specificity of 94.7%, and the area under the ROC curve of 0. 985. CONCLUSION Doppler ultrasound can evaluate the gallbladder morphology of acute infectious cholecystitis, gallbladder wall thickness or roughness, sound through the bile, and ultrasonographic Murphy sign, improving the accuracy of qualitative diagnosis of the disease.