超声造影与增强CT在胆囊息肉样病变诊断中的比较

Comparative analysis of contrast-enhanced ultrasound and enhanced CT in diagnosis of polypoid lesions of gallbladder

目的通过比较胆囊息肉样病变行超声造影与增强CT的结果,探讨超声造影在胆囊息肉样病变鉴别诊断中的应用价值。方法分析2014年1月至2018年1月浙江省台州市立医院肝胆外科胆囊息肉样病变≥1.0 cm共68例患者临床资料,术前均行常规B超、超声造影及增强CT检查,根据术后病理结果比较影像学方法诊断准确率的差异。结果超声造影检查结果与常规B超比较,诊断结果一致性较差(Kappa=0.115,P=0.265);超声造影诊断准确度92.6%,明显高于常规B超的79.4%,差异具有统计学意义(P=0.035)。超声造影与与增强CT比较,诊断结果一致性较好(Kappa=0.641,P<0.001);诊断准确度上,超声造影92.6%,与增强CT的91.9%差异无统计学意义(P=1.000)。结论超声造影在胆囊息肉样病变的鉴别诊断中与增强CT价值相当,值得推广应用。

Objective To evaluate the value of contrast-enhanced ultrasonography in the differential diagnosis of gallbladder polypoid lesions by comparing with enhanced CT. Methods The clinical data of 68 patients with polypoid lesions of gallbladder ≥ 1.0 cm admitted to Taizhou Municipal Hospital between Jan. 2014 and Jan. 2018 was analyzed. All patients underwent routine B-ultrasound, contrast-enhanced ultrasound and enhanced CT before operation. The accuracy of imaging diagnosis was calculated according to postoperative pathological results. Results The diagnostic accuracy of contrast-enhanced ultrasound was 92.6%, which was significantly higher than that of routine B ultrasound (79.4%, P=0.035), and the consistency of diagnostic results was poor (Kappa=0.115, P=0.265). The diagnostic consistency of contrast-enhanced ultrasound and enhanced CT was good (Kappa=0.641, P<0.001), there was no significant difference in diagnostic accuracy between contrast-enhanced ultrasound (92.6%) and enhanced CT (91.9%, P=1.000). Conclusion Contrast-enhanced ultrasonography has the same value as enhanced CT in the differential diagnosis of polypoid lesions of gallbladder.