超声造影到达时间参数成像鉴别诊断胆囊病变

Arrival time parametric imaging of contrast enhanced ultrasound for differential diagnosis of gallbladder lesions

目的观察超声造影到达时间参数成像鉴别诊断胆囊病变的价值。方法回顾分析25例胆囊癌和22例胆囊良性病变胆囊患者的超声检查资料,根据到达时间参数成像评估灌注动脉模式,评价到达时间参数,包括病灶到达时间、同深度肝组织到达时间、病灶与同深度肝组织的到达时间差(△T)。结果胆囊良恶性病变间灌注动脉模式差异有统计学意义(P<0.001)。恶性病变动脉模式多呈分支型和不规则型,良性病变多呈散在点状型和单支型,而病灶到达时间差异无统计学意义(P>0.05)。良恶性病变之间△T[造影剂到达胆囊与到达同深度肝组织的时间差,分别为(-0.21±1.37)s和(-2.69±1.37)s]差异有统计学意义(P<0.001)。取△T截断值为-1.05 s,其诊断敏感度、特异度、阳性预测值、阴性预测值和准确率分别为81.80%、92.00%、85.20%、90.00%和87.20%。结论超声造影到达时间参数成像有助于鉴别诊断胆囊良恶性病变。

Objective To explore the value of arrival time parametric imaging(ATPI)of contrast-enhanced ultrasonography(CEUS)for differential diagnosis of gallbladder lesions.Methods Data of 25 patients with gallbladder carcinoma and 22 with benign gallbladder lesions who received CEUS and cholecystectomy were reviewed.ATPI system was used to analyze CEUS imaging.The artery patterns of the lesions on ATPI in artery phase were evaluated.Then quantitative parameters,including arrival time of gallbladder lesions,arrival time of surrounding liver as well as the time difference(△T)were analyzed.Results The artery patterns were different between benign and malignant gallbladder lesions in artery phase(P<0.001).Malignant lesions often presented as branched and irregular artery pattern,while benign lesions tended to present as scattered dot and linear artery pattern,but the arrival time of them were not statistical different(P>0.05).However,△T(the arrival time difference of lesions and the surrounding liver)of benign(-0.21±1.37)s and malignant(-2.69±1.37)s lesions were statistically significant(P<0.001).Taken-1.05 s as the cut off value of△T,the sensitivity,specificity,positive predictive value,negative predictive and value accuracy in differentiating gallbladder carcinoma from benign lesions was 81.80%,92.00%,85.20%,90.00%and 87.20%,respectively.Conclusion Artery patterns and parameters of ATPI of CEUS are helpful to differential diagnosis of benign and malignant gallbladder lesions.