彩色多普勒超声在肝脏实质占位性病变诊断中的临床分析

Clinical analysis of color Doppler ultrasound in the diagnosis of liver parenchymal space-occupying lesions

目的分析彩色多普勒超声在肝脏实质占位性病变诊断中的应用价值。方法选取81例肝脏实质占位性病变患者作为研究对象,均于入院后行常规超声、彩色多普勒超声检查。统计分析病理检查结果、常规超声及彩色多普勒超声诊断结果,以病理检查结果为金标准,对比常规超声与彩色多普勒超声诊断恶性肝脏实质占位性病变的价值,并对比良性与恶性病变患者的多普勒超声诊断参数[血流灌注指数(DPI)、门静脉充血指数(PCI)、阻力比(RR)以及肝总血流量(TLBF)]。结果病理检查结果显示:36例患者为恶性病变,其中25例为原发性肝癌,11例为转移性肝癌;另外45例为良性病变,其中14例为肝血管瘤,10例为炎性假瘤,13例为肝硬化结节,8例为局灶性结节增生。常规超声检查显示:37例患者为恶性病变,44例患者为良性病变,其中50例患者的诊断结果与病理检查结果相符。彩色多普勒超声检查显示:34例患者为恶性病变,47例患者为良性病变,其中75例患者的诊断结果与病理检查结果相符。彩色多普勒超声诊断恶性肝脏实质占位性病变的准确率、特异度、敏感度均高于常规超声诊断,差异具有统计学意义(P<0.05)。恶性病变患者RR、DPI、TLBF、PCI值分别为(1.32±0.21)、(0.40±0.11)、(1273.54±259.64)ml/min、(8.17±1.58),良性病变患者RR、DPI、TLBF、PCI值分别为(1.05±0.17)、(0.19±0.05)、(1458.63±211.62)ml/min、(12.31±2.06);恶性病变患者RR、DPI高于良性病变患者,TLBF、PCI低于良性病变患者,差异均具有统计学意义(P<0.05)。结论恶性肝脏实质占位性病变有明显血流异常表现,彩色多普勒超声鉴别诊断病灶性质的准确性优于常规超声,具有推广使用价值。

Objective To analyze the practical value of color Doppler ultrasound in the diagnosis of liver parenchymal space-occupying lesions.Methods 81 patients with liver parenchymal space-occupying lesions were selected as the research subjects,and all of them underwent conventional ultrasound and color Doppler ultrasound examinations after admission.The results of pathological examination,conventional ultrasound and color Doppler ultrasound were statistically analyzed.Taking pathological examination results as the gold standard,the value of conventional ultrasound and color Doppler ultrasound in the diagnosis of malignant liver parenchymal space-occupying lesions was compared,and the diagnostic parameters of Doppler ultrasound[Doppler perfusion index(DPI),portal congestion index(PCI),resistance ratio(RR)and total liver blood flow(TLBF)]were compared between benign and malignant lesions.Results The results of pathological examination showed that 36 patients had malignant lesions,including 25 cases of primary liver cancer and 11 cases of metastatic liver cancer;the other 45 cases had benign lesions,including 14 cases of hepatic hemangioma,10 cases of inflammatory pseudotumor,13 cases of cirrhotic nodules and 8 cases of focal nodular hyperplasia.Conventional ultrasound examination showed that 37 patients had malignant lesions and 44 patients had benign lesions.Among them,the diagnosis results of 50 patients were consistent with the pathological examination results.Color Doppler ultrasound examination showed that 34 patients had malignant lesions and 47 patients had benign lesions.Among them,the diagnosis results of 75 patients were consistent with the pathological examination results.The accuracy,specificity and sensitivity of color Doppler ultrasound in diagnosing malignant liver parenchymal space-occupying lesions were higher than those of conventional ultrasound,and the difference was statistically significant(P<0.05).The RR,DPI,TLBF and PCI values of patients with malignant lesions were(1.32±0.21),(0.40±0.11),(1273.54±259.64)ml/min,(8.17±1.58),which were(1.05±0.17),(0.19±0.05),(1458.63±211.62)ml/min,(12.31±2.06)of patients with benign lesions,and the difference was statistically significant(P<0.05).Conclusion The malignant liver parenchymal space-occupying lesions have obvious blood flow abnormalities.Color Doppler ultrasound is more accurate than conventional ultrasound in the differential diagnosis of the nature of the lesion,and it has the value of promotion and application.