超声造影与彩色多普勒超声在肝肿瘤诊断中的对比

Comparison of Contrast Enhanced Ultrasound and Color Doppler Ultrasound in the Diagnosis of Liver Tumor

目的探讨超声造影与彩色多普勒超声在肝肿瘤诊断中的临床价值。方法选取80例肝肿瘤患者,先行彩色多普勒超声检查,然后注入造影剂,进行超声造影检查。通过观察2种检测手段的血流信号分级,各类型肝肿瘤的诊断结果及肝脏良恶性病变的最大流速(Vmax)和阻力指数(RI)值,对比超声造影与彩色多普勒超声在肝肿瘤诊断中的临床价值。结果超声造影对HCC的血流显示率为88.0%,彩色多普勒超声对HCC血流显示率为68.0%,超声造影的血流显示率明显较高(P<0.05);2种检测方法在MLC,HHA的血流显示率上相比,无统计学差异(P>0.05)。以病理诊断结果为金标准,超声造影对各类型肝脏肿瘤的诊断准确率高于彩色多普勒超声诊断的准确率(P<0.05)。采用彩色多普勒超声与超声造影测得的肝脏良恶性病变Vmax相比,无统计学差异(P>0.05)。采用彩色多普勒超声与超声造影测得肝癌的RI均要高于肝脏良性病变(P<0.05),但2种检测方法间RI值相比,无统计学差异(P>0.05)。结论超声造影可以较为准确地检测肝肿瘤,对肿瘤内血流信号敏感度和特异性较高,也能较好地区分肝脏良恶性病变,具有较好的临床应用价值。

Objective To discuss the clinical value of contrast enhanced ultrasound and color doppler ultrasound in the diagnosis of liver tumor. Methods 80 patients with liver tumor were selected, they were first given color doppler ultrasound and then injected contrast agent to do contrast enhanced ultrasound. The clinical value of contrast enhanced ultrasound and color doppler ultrasound in the diagnosis of liver tumor was evaluated by blood flow grade, diagnosis of liver tumor and Vmax and RI of hepatic benign and malignant lesions. Results The display rate of HCC was 88.0% by contrast enhanced ultrasound and 68.0% by eolor doppler ultrasound. The display rate of HCC was higher by contrast enhanced ultrasound （P 〈 O. 05）. There were no sta- tistical significance on display rate of MLC and HHA between the 2 methods（ P 〉 0.05 ）. By taking the pathological diagnosis as gold standard, the accuracy rate of live tumors by contrast enhanced ultrasound was higher than that of the color doppler ultrasound （P 〈0.05）. There were no statistical significance in Vmax between the 2 methods（P 〉0.05）. The RI of liver cancer was higher than that of the benign liver disease （ P 〈 0.05 ）. But there were no statistical significance in RI value between the 2 methods （ P 〉 0.05）. Conclusion Contrast enhanced ultrasound could accurately detect liver tumor. The sensitivity and specificity of tumor blood flow are higher. It could distinguish hepatic benign and malignant lesions accurately with good clinical annlicntion value.