四维超声造影在肝脏肿瘤定性诊断中的价值研究

Value of four-dimensional contrast-enhanced ultrasound imaging in the qualitative diagnosis of liver tumors

目的探讨四维超声造影在肝脏肿瘤定性诊断中的价值研究。方法收集2012年3月至2014年7月进行肝脏检查的104例患者，所有患者先采用常规超声检查，再采用四维超声造影检查，比较所有患者不同方式检查下的检查结果，分析常规和四维超声造影检查下肝肿瘤的漏诊、误诊和良恶性病灶的检出率及四维超声造影检查在肝肿瘤定性诊断中的临床价值。结果常规超声检查病灶数（85．6±3．9）个，漏诊16例，误诊9例。检出率为75．9％；四维超声造影检查病灶数（97．7±4．3）个，漏诊2例，误诊1例，检出率为97．1％，两组检查方法比较差异有统计学意义（P〈0．05）。104例患者中70例为肿瘤患者或待定患者，34例为非肿瘤患者。常规超声检查中良性肝肿瘤32例，恶性肝肿瘤23例，待定15例；四维超声造影检查出良性肝肿瘤35例，恶性肝肿瘤32例，待定3例，两种检查方法比较差异有统计学意义（P〈0．05）。结论与常规超声相比，四维超声造影图像立体感、层次感更强，能动态、连续显示肝肿瘤灌注及其滋养血管特征，具有明显的优势，能够实现良恶性肿瘤的初步鉴别诊断，可作为一种辅助肝肿瘤诊断的新方法。

Objective To investigate the value of the four-dimensional contrast-enhanced ultrasound in the qualitative diagnosis of liver tumors. Methods From March 2012 to July 2014, 104 liver patients underwent liver examination. All patients use conventional ultrasound, and then use four-dimensional contrast-enhanced ultrasound to compare the test results in different ways, and analyze the diagnosis, misdiagnosis, detection rate of benign and malignant lesions and the diagnostic value of four dimensional contrast-enhanced ultrasonography in the diagnosis of liver tumors. Results The number of lesions was 85.6 ± 3.9 examined by conventional ultrasound, 16 cases of missed diagnosis, 9 cases of misdiag- nosis, the detection rate was 75.9% ; the number of lesions was 97.7 ±4.3 examined by four-dimension- al contrast-enhanced ultrasound, 2 cases of missed diagnosis, 1 case of misdiagnosis, the detection rate was 97. 1% , the difference was significant（P 〈0. 05）. Among the 104 cases, 70 cases were tumor patients or to be determined, 34 cases were non tumor patients. Thirty-two cases of benign liver tumors, 23 cases of malignant liver were determined by examination; 35 cases of tumors and 15 cases routine ultrasound benign liver tumors,32 cases of malignant liver tumors and 3 cases were determined by four-dimensional contrast-enhanced ultrasound, the difference was significant between the two groups （P 〈 0. 05 ）. Conclusions Compared with conventional ultrasound, the four-dimensional ultrasound imaging has a stronger sense of layered and three-dimensional, dynamic and continuous display of hepatic tumor perfusion and its nutrient vessels has obvious advantages, so it is likely to achieve the initial differential diagnosis of benign and malignant tumors. It can be as a new method for the diagnosis of liver tumors.