胃肠超声造影与声脉冲辐射力成像诊断胃壁常见良恶性病变的对比研究

Value of gastrointestinal contrast-enhanced ultrasonography and acoustic pulse radiation force imaging in the diagnosis of benign and malignant lesions of gastric wall

目的对比分析胃肠超声造影与声脉冲辐射力成像(ARFI)对胃壁常见良恶性病变的诊断价值。方法回顾性分析67例胃壁增厚患者的临床资料,根据病理结果分为良性组49例和恶性组18例。两组患者均行胃肠超声造影和ARFI,比较胃半排空时间(t1/2)、胃窦动力指数(MI)及剪切波速度(SWV);绘制受试者工作特征(ROC)曲线比较上述指标对胃壁常见恶性病变的诊断效能。结果良性组和恶性组患者的t1/2分别为(73.04±18.65)min和(84.20±21.44)min,MI分别为63.37±21.05和52.22±16.55,差异均有统计学意义(均P<0.05)。良性组和恶性组患者的SWV分别为(1.38±0.26)m/s和(2.41±0.74)m/s,差异有统计学意义(P<0.05)。ROC曲线分析显示,t1/2、MI、SWV诊断胃壁常见恶性病变的截断值分别为100.625 min、62.42、1.66 m/s,敏感性分别为38.9%、50.0%、87.9%,特异性分别为100%、51.0%、81.8%,曲线下面积分别为0.671、0.260、0.935。结论 ARFI诊断胃壁常见良恶性病变的价值优于胃肠超声造影,可为临床诊断胃壁常见良恶性病变提供新思路。

Objective To investigate the diagnostic value of gastrointestinal contrast-enhanced ultrasonography and acoustic pulse radiation force imaging(ARFI) in benign and malignant lesions of gastric wall.Methods A total of 67 patients with thickened gastric wall were retrospectively analyzed.They were divided into benign group(49 cases) and malignant group(18 cases) according to the results of pathological biopsy.Both groups of patients underwent gastrointestinal contrast-enhanced ultrasonography and ARFI,gastric emptying half-time(t1/2),gastric antrum motility index(MI) and shear wave velocity(SWV)were recorded.ROC curve were drawn to compare the diagnostic efficacy of the above indicators in common malignant lesions of gastric wall.Results The t1/2 and SWV of benign group were(73.04±18.65) min and(1.38±0.26)m/s,respectively,which were lower than those of malignant group[(84.20±21.44) min and(2.41±0.74)m/s].The MI was 63.37±21.05 in benign group,which was higher than that of malignant group(52.22±16.55),and the difference were statistically significant(all P<0.05).ROC curve analysis showed that the cutoff values of t1/2,MI and SWV were 100.625 min,62.42 and 1.66 m/s,respectively,the sensitivity were 38.9%,50.0% and 87.9%,the specificity were 100%,51.0% and 81.8%,respectively,the areas under the curve were0.671,0.260 and 0.935,respectively.Conclusion The value of ARFI in the diagnosis of common benign and malignant lesions of gastric wall is superior to that of gastrointestinal contrast-enhanced ultrasonography.