超声造影在胆囊息肉样病变中的诊断价值

Value of Contrast-enhanced Ultrasonography in Diagnosis of Polypoid Lesion of Gallbladder

目的探讨超声造影在胆囊息肉样病变中的诊断价值。方法 2015年1月—2017年9月,共纳入85例患有胆囊息肉样病变、行超声造影检查、接受手术治疗的病例。依据病理结果将研究对象分为3组:良性组、腺瘤组、恶性组。观察指标为:增强开始时间、增强变低时间、造影剂分布特征,胆囊壁的完整性。比较各观察指标在三组间是否有差异,判断各指标的诊断价值。结果良性组与腺瘤组在增强开始时间、增强变低时间、造影剂分布特征、胆囊壁完整性上差异无统计学意义(F=1.093,P=0.340)。恶性组与良性组、恶性组与腺瘤组比较,在增强开始时间上差异无统计学意义(P>0.05),在增强变低时间、造影剂分布特征、胆囊壁完整性上均差异显著(P<0.05),对增强变低时间构建ROC曲线,曲线下面积为0.815,约登指数最大值为0.641,对应的界值为35.5 s,以增强变低时间<35.5 s来诊断恶性胆囊息肉样病变的敏感度为80.0%、特异性为84.1%。超声造影诊断胆囊息肉样病变的准确率为81.2%。结论超声造影在胆囊息肉样病变的诊断中具有较高的临床应用价值。

Objective To study the value of contrast-enhanced ultrasonography in diagnosis of polypoid lesion of gallbladder.Methods 85 cases of patients with polypoid lesion of gallbladder for contrast-enhanced ultrasonography from January 2015 to September 2017 were selected,the enhanced starting time,enhanced decreasing time,distribution features of contrast agent and integrity of gallbladder wall were observed,and the differences were compared thus determining the diagnostic value of various indicators.Results The differences in the enhanced starting time,enhanced decreasing time,distribution features of contrast agent and integrity of?gallbladder wall between the benign group and adenoma group were not obvious(F=1.093,P=0.340),and the difference in the enhanced starting time between the malignant group and benign group,malignant group and adenoma group was not statistically significant(P>0.05),and the differences in the enhanced decreasing time,distribution features of contrast agents and integrity of gallbladder wall were obvious(P>0.05),and the differences in the enhanced decreasing time,distribution features of contrast agents and integrity of gallbladder wall were obvious(P<0.05),and the ROC carve was constructed at the enhanced decreasing time,and the area under the curve was 0.815,the maximal value of Youden index was 0.641,and the corresponding dividing value was 35.5 s,and the sensitivity and specificity of diagnosis of malignant polypoid lesion of gallbladder in less than 35.5 s of enhanced decreasing time were 80.0%and 84.1%,and the accuracy of contrast-enhanced ultrasonography in diagnosis of polypoid lesion of gallbladder was 81.2%.Conclusion The clinical application value of contrast-enhanced ultrasonography in diagnosis of polypoid lesion of gallbladder is higher,which is worth recommendation in clinic.