超声造影用于诊断肝脓肿的影像学表现及临床价值研究

Imaging manifestations and clinical value of contrast enhanced ultrasound in diagnosis of liver abscess

目的探讨超声造影用于诊断肝脓肿的影像学表现及临床价值,为肝脓肿的诊断方法选择提供参考。方法收集2010年1月-2016年6月医院确诊的100例肝脓肿患者临床资料,分析术前常规二维超声及超声造影检查结果。结果常规二维超声术前诊断为肝脓肿者89例,诊断准确率89.00%,其中脓肿炎性期、脓肿形成初期、脓肿形成期的诊断准确率分别为72.22%、88.57%、95.74%,不同分期患者诊断准确率比较,差异有统计学意义(P<0.05);超声造影术前诊断为肝脓肿者97例,诊断准确率97.00%,诊断准确率高于常规二维超声(P<0.05),其中脓肿炎性期、脓肿形成初期、脓肿形成期的诊断准确率分别为88.89%、97.14%、100.00%,不同分期患者诊断准确率比较差异有统计学意义(P<0.05);超声造影检查时脓肿炎性期、脓肿形成初期影像学表现主要表现为病灶动脉期的高增强,静脉期、延迟期低增强,显示范围较常规超声增大,脓肿形成期影像学表现为病灶动脉期高增强,静脉期、延迟期低增强现象减少,显示范围较常规超声增大。结论超声造影用于诊断肝脓肿能明显提高诊断准确性,影像学上肝脓肿不同时期超声造影表现各有特点。

OBJECTIVE To explore the imaging manifestations and clinical value of contrast enhanced ultrasound in diagnosis of liver abscess so as to provide guidance for diagnosis of liver abscess. METHODS The clinical data were collected from 100 patients with confirmed liver abscess who were treated in the hospital from Jan 2010 to Jun 2016. The results of preoperative two-dimensional ultrasonography and contrast enhanced ultrasound examination were observed. RESULTS Totally 89 patients were diagnosed with liver abscess by the two-dimensional ultrasonography before surgery, with the rate of accurate diagnosis 89.00% ; the rates of accurate diagnosis of inflammatory stage of abscess, initial stage of abscess formation, and formation stage of abscess were 72. 22%, 88.57%, and 95.74 %, respectively; as compared with the rates of accurate diagnosis in the different stages, there was significant difference （P〈0.05）. Totally 97 patients were diagnosed with liver abscess by the contrast enhanced ultrasound before surgery, with the rate of accurate diagnosis higher than that of the conventional two-dimensional ultrasonography （P〈0.05） ; the rates of accurate diagnosis of inflammatory stage of abscess, initial stage of abscess formation, and formation stage of abscess were 88.89%, 97.14%, and 100.00%, respectively, and there was significant difference in the rate of accurate diagnosis among the patients with different stages of liver abscess （P〈 0. 05）. The contrast-enhanced ultrasound examination showed that the major imaging manifestations of inflammatory stage of abscess and initial stage of abscess formation included the high enhancement of lesions in the arterial phase and low enhancement in venous phase, or delayed phase, and the display range of the contrast-enhanced ultrasound was larger than that of the conventional ultrasound; the imaging manifestations of formation period of abscess included the high enhancement of lesions in arterial phase and decrease of low enhancement of lesions in venous phase or delayed phase, and the display range of the contrast-enhanced ultrasound was larger than that of the conventional ultrasound. CONCLUSION The contrast-enhanced ultrasound can remarkably raise the accuracy of diagnosis of liver absecess, and the imaging manifestations of the contrast-enhanced ultrasound vary in different phases of liver abscess.