摘要
目的评估超微血管成像(superbmicrovascularimaging,SMI)显示肝局灶性病变微血管血流信号的价值。方法对54例患者共56个肝局灶性病变分别行彩色多普勒血流显像(CDFI)和SMI检查,由2名观察者对图像采用Adler半定量法进行血流分级,分析不同观察者间分级的一致性;并以超声造影为参考标准,分析两者显示血流信号能力的差异。结果两位观察者对图像进行Adler血流半定量分级,CDFI和SMI的一致性分级分别为中度(K=0.579)和高度(K=0.605)。56个病灶在三种血流成像技术显示血管的Adler半定量分级为0级、Ⅰ级、Ⅱ级、Ⅲ级的病灶个数分别为:CDFI显示4个(7.14%),25个(42.86%),14个(25%),14个(25%);sMI显示0个(0%),12个(21.43%),12个(19.64%),33个(58.93%);超声造影显示0个(0%),3个(5.36%),21个(37.50%),32个(57.14%)。以超声造影微血管成像动脉期所显示病灶血管分级为参考标准,CDFI血流分级的符合率为30.35%,SMI血流分级的符合率为73.21%(P〈0.01)。结论SMI具有更好的观察者间一致性,其显示肝局灶性病变微血流信号的能力优于CDFI,能显示更微小血管,在肝局灶性病变的鉴别诊断中具有潜在应用价值。
Objective To estimate the value of superb microvascular imaging(SMI) in the detection of microvascular flow signal of focal liver lesions(FLLs). Methods A total of 54 patients with 56 FLLs who had underwent CDFI(Color Doppler Flow imaging) and SMI were included in this study. Adler semi- quantitative assessment was used to grade the distribution of blood flow signal for each FLL by two observers,then inter-observer agreement was assessed. The distribution of blood flow grade between CDFI and SMI was also compared with contrast-enhanced ultrasound(CEUS) as the reference standard. Results The inter-observer agreement for Adler semi-quantitative grading were fair ( K = 0.579) on CDFI and good ( K = 0.605) on SMI,respectively. The grade 0, Ⅰ , Ⅱ and Ⅲ of Adler semi-quantitative grading of all total 56 FLLs' blood flow signal on three flow imaging tools were 4(7.14%),25(42.860/00),14(25%), 14(25%) on CDFI,0(0%),12(21.43%0),12(19.64%),33(58.93%) on SMI,and 0(0%) ,3(5.36%),21 (37.50%/00),32 (57.14%) on CEUS micro-flow imaging, respectively. With CEUS blood flow distribution in the arterial phase as the reference, the coincidence rate of CDFI was 30.35~/~, while that of SMI was 73.21%. The distinction of ability on FLLrs micro-vascular imaging between CDFI and SMI was statistically significant ( P 〈0.01 ). Conclusions The inter-observer agreement of SMI was better than that of CDFI and its capacity in displaying FLL's micro-vascular was superior to CDFI, SMI can exhibit more tiny vessels and thus SMI may possess potential value in the differential diagnosis of FLLs.
出处
《中华超声影像学杂志》
CSCD
北大核心
2015年第10期850-854,共5页
Chinese Journal of Ultrasonography
关键词
超声检查
肝局灶性病变
超微血管成像
Ultrasonography
Focal liver lesions
Superb microvascular imaging