超声造影和增强CT对肝脏局灶性病变定性诊断的对比研究

A Comparison of Contrast-Enhanced Ultrasound and Contrast-Enhanced CT for Qualitative Diagnosis of Focal Liver Lesion

目的比较超声造影(CEUS)和增强CT(CECT)对肝局灶性病变(FLL)的定性诊断价值。方法 137例FLL患者共137个病灶,其中良性病灶51个,恶性病灶86个,均行CEUS和CECT检查。结果以病理检查结果为诊断金标准,CEUS及CECT对病灶直径≤2 cm的FLL诊断敏感性为91.0%(20/22)及94.5%(17/18),特异性为59.1%(13/22)及18.8%(3/16),CEUS的特异性明显高于CECT;对于病灶直径≤2 cm的肝细胞癌及肝硬化再生结节,CEUS的诊断价值高于CECT。CEUS及CECT对病灶直径>2 cm的FLL诊断的敏感性分别为97.7%(42/43)、94.4%(52/55),特异性分别为75.0%(15/20)、57.1%(12/21),均无明显差异;对于病灶直径>2 cm的肝细胞癌及肝硬化再生结节,CEUS与CECT的诊断效果相当。结论 CEUS和CECT诊断FLL均有较高的敏感性,合理使用CEUS及CECT能提高FLL的临床诊断。

Objective To compare the efficiency of contrast-enhanced ultrasound（CEUS） and contrast-enhanced CT（CECT） for qualitative diagnosis of focal liver lesion（FLL）.Methods Of 137 focal liver lesions in 137 patients,fifty-one lesions were benign and 86 lesions were malignant,all the patients received the examination with CEUS and CECT.Results Taking the pathological results as Golden standard,the sensitivity of CEUS was 91.0%（20/22） for FLL with diameter≤2 cm,and of CECT was 94.5%（17/18）,the specificity of CEUS was 59.1%（13/22）,and of CECT was 18.8%（3 /16）,the specificity of CEUS was significantly higher than that of CECT;For hepatocellular carcinoma and regenerative nodules with diameter ≤2 cm,CEUS had better diagnostic effect compared with CECT.The sensitivity of CEUS was 97.7%（42 /43） for FLL with diameter 2 cm,and of CECT was 94.4%（52 /55）,the specificity of CEUS was 75.0%（15 /20）,and of CECT was 57.1%（12 /21）,there was no significant difference;For hepatocellular carcinoma and regenerative nodules with diameter 2 cm,CEUS had a diagnostic effect similar to that of CECT.Conclusion Both CEUS and CECT have high sensitivity in the diagnosis of FLL,and reasonable application of CEUS and CECT can improve the diagnosis efficiency of FLL.