实时超声造影对肝脏恶性肿瘤鉴别诊断的应用

Application of Real-time Contrast-enhanced Ultrasound in Differential Diagnosis of Liver Malignant Tumors

目的研究实时超声造影对肝脏恶性肿瘤鉴别诊断的应用。方法选取2017年1月至2018年12月河北省中医肝病医院肝病科住院治疗的肝脏疾病患者62例作为研究对象,同时给予常规超声检查和实时超声造影检查,并对高度怀疑恶性肿瘤的患者进一步给予病理学活检以确认,比较两种检查手段恶性肿瘤检出率,并对经实时超声造影检测出的肝脏恶性肿瘤的造影时间-强度曲线各参数进行比较。结果实时超声造影的肝脏恶性肿瘤检出率明显高于常规超声的肝脏恶性肿瘤检出率(90.32%vs.64.51%,P<0.05)误诊率为明显低于常规超声(3.22%vs.12.90%,P<0.05)。肝细胞癌、转移性肝癌、胆管细胞癌三种肝癌的造影时间-强度曲线参数比较,差异有统计学意义(P<0.05)。结论实时超声造影能够更加准确的检测出肝脏恶性肿瘤,分辨恶性肿瘤类型,从而为临床制定治疗方案提供参考数据。

Objective To study the application of real-time contrast-enhanced ultrasound in differential diagnosis of liver malignant tumors.Methods Sixty-two patients with liver diseases hospitalized in our hospital from January 2017 to December 2018 were selected as the subjects.All patients underwent routine ultrasonography and real-time contrast-enhanced ultrasonography at the same time,respectively.Pathological biopsy was further performed to confirm highly suspected malignant tumors.The detection rates of malignant tumors by the two methods were compared,and real-time contrast-enhanced ultrasonography was used to distinguish the types of malignant tumors.The parameters of contrast time-intensity curve of hepatic malignant tumors were compared.Results The detection rate of liver malignant tumors by real-time contrast-enhanced ultrasound was higher than that by conventional ultrasound(90.32%vs.64.51%,P<0.05),the misdiagnosis rate was much lower than that of conventional ultrasound(3.22%vs.12.90%,P<0.05).The time-intensity curve parameters of hepatocellular carcinoma,metastatic hepatocellular carcinoma and cholangiocarcinoma were analyzed,and the difference was statistically significant(P<0.05).Conclusion Real-time contrast-enhanced ultrasound can detect liver malignant tumors more accurately and distinguish the types of malignant tumors,so as to provide reference data for clinical treatment,which has very important clinical value.