多模态超声成像技术在肝癌高危人群筛查中综合运用策略研究

Application value of multi-modal ultrasound imaging in screening high risk population of liver cancer

目的探讨多模态超声成像技术在肝癌高危人群筛查中的综合运用价值。方法选取2020年1月至2021年2月在海南省肿瘤医院诊治的肝癌高危病例200例,均给予超声弹性成像和超声造影辅助诊断,以患者的病理结果作为金标准,比较超声弹性成像、超声造影及二者联合对的肝癌的诊断价值。结果200例肝癌高危人群经病理结果确诊为肝癌36例,肝癌发生率为18.00%。超声弹性成像、超声造影诊断肝癌的准确性均为86.00%,明显低于二者联合的94.00%(χ^(2)均=7.111,P均<0.05);超声弹性成像、超声造影诊断肝癌的敏感度分别为63.89%、69.44%,明显低于二者联合的91.67%(χ^(2)=8.036、5.675,P均<0.05);超声弹性成像、超声造影诊断肝癌的特异度分别为90.85%、89.63%,明显低于二者联合的96.34%(χ^(2)=4.121、5.658,P均<0.05);超声弹性成像、超声造影诊断肝癌的阳性预测值分别为60.53%、59.52%,明显低于二者联合的84.62%(χ^(2)=5.631、6.262,P均<0.05);超声弹性成像、超声造影诊断肝癌的阴性预测值分别为91.98%、93.04%,明显低于二者联合的98.14%(χ^(2)=6.511、4.940,P均<0.05)。结论肝癌高危人群具有较高的肝癌发生率,采用多模态超声成像技术对肝癌高危人群进行筛查具有较高的诊断价值,可提高肝癌高危人群的筛查准确性、敏感度和特异度。

Objective To investigate the application value of multi-modal ultrasound imaging technology in screening high-risk population of liver cancer.Methods Two hundred patients with high risk of liver cancer admitted to our hospital from January 2020 to February 2021 were selected,and all of them underwent ultrasound elastography and contrast-enhanced ultrasound.Pathological results were used as the gold standard to analyze the diagnostic value of ultrasound elastography,contrast-enhanced ultrasound and the combination of the 2 in liver cancer.Results Thirty-six cases were diagnosed as liver cancer based on pathological results,and the incidence of liver cancer was 18.00%.The accuracy rates of ultrasound elastography and contrast-enhanced ultrasound in diagnosing liver cancer were both 86.00%,which were significantly lower than that of the combination of the 2 methods(94.00%)(χ^(2)=7.111,P<0.05).The sensitivity of ultrasound elastography and contrast-enhanced ultrasound in diagnosing liver cancer were 63.89%and 69.44%respectively,which were significantly lower than that of the combination of the 2 methods(91.67%)(χ^(2)=8.036,5.675,P<0.05);the specificity of ultrasound elastography and contrast-enhanced ultrasound were 90.85%and 89.63 respectively,which were significantly lower than that of the combination method(96.34%)(χ^(2)=4.121,5.658,P<0.05);the positive predictive values of ultrasound elastography and contrast-enhanced ultrasound were 60.53%and 59.52%,which were significantly lower than than that of the combination method(84.62%)(χ^(2)=5.631,6.262,P<0.05);the negative predictive values of ultrasound elastography and contrast-enhanced ultrasound were 91.98%and 93.04%,which were significantly lower than than that of the combination method(98.14%)(χ^(2)=6.511,4.940,P<0.05).Conclusion The population with high risk of liver cancer is more likely to develop liver cancer.The multi-modal ultrasound imaging technology has a high diagnostic value in screening high-risk population of liver cancer,and can improve the accuracy,sensitivity and specificity of screening.