超声造影在肝实质性肿块诊断及鉴别中的临床价值

Clinical Value of Contrast-enhanced Ultrasonography in the Diagnosis and Differential Diagnosis of Liver Mass

目的探讨超声造影在肝实质性肿块诊断及鉴别中的临床价值。方法选取2016年7月~2017年8月我院检查的疑似肝实质性肿块患者90例,所有患者均给予超声造影及彩色多普勒超声检查,对比两种方法在肝实质性肿块中的检出率,诊断肝实质性肿块中恶性肿瘤、良性肿瘤及良性病变的灵敏度及特异度。结果90例患者中,共检出110个肝实质性肿块,恶性肿瘤71个,其中为肝转移癌16个、原发性肝癌55个;良性肿瘤为肝血管瘤25个;良性病变14个,其中为肝孤立性坏死结节4个、肝局灶性结节增生10个。超声造影在恶性肿瘤、良性肿瘤及良性病变检出率高于彩色多普勒超声检查,差异有统计学意义(P<0.05)。超声造影在诊断肝实质性肿块中灵敏度及特异度均高于彩色多普勒超声检查,但差异无统计学意义(P>0.05)。结论超声造影与彩色多普勒超声检查均可诊断及鉴别肝实质性肿块,但超声造影在诊断及鉴别中优势更加明显,肿块检出率及临床应用价值较高,可为临床诊断提供影像学参考。

Objective To explore the clinical value of contrast-enhanced ultrasound in the diagnosis and identification of solid liver masses.Methods 90 patients with suspected hepatic solid masses examined in our hospital from July 2016 to August 2017 were enrolled.All patients underwent contrast-enhanced ultrasonography and color Doppler ultrasonography.The two methods were compared in the liver mass.Outcome rate,the sensitivity and specificity of diagnosis of malignant tumors,benign tumors and benign lesions in solid liver masses.Results Of the 90 patients,110 liver masses and 71 malignant tumors were detected,including 16 liver metastases and 55 primary liver cancers;benign tumors were hepatic hemangioma 25;There were 14 benign lesions,including 4 isolated solitary necrotic nodules and 10 focal hepatic nodular hyperplasia.The detection rate of contrast-enhanced ultrasound in malignant tumors,benign tumors and benign lesions was higher than that of color Doppler ultrasonography,the difference was statistically significant(P<0.05).The sensitivity and specificity of contrast-enhanced ultrasonography in the diagnosis of hepatic solid mass were higher than those of color Doppler ultrasonography,but the difference was not statistically significant(P>0.05).Conclusion Both contrast-enhanced ultrasonography and color Doppler ultrasonography can diagnose and identify liver masses.However,the advantages of contrast-enhanced ultrasound in diagnosis and differentiation are more obvious.The detection rate and clinical value of the tumor are high,which can provide imaging for clinical diagnosis reference.