超声造影在鉴别肝脏良、恶性局灶性病变中的应用

Application of Contrast-enhanced Ultrasound in Differentiating Benign and Malignant Focal Lesions of the Liver

目的通过回顾性分析肝脏局灶性病变的超声造影表现,探讨超声造影对肝脏局灶性病变性质的鉴别诊断价值。方法选取2019年9月至2021年9月在我院接受常规超声及超声造影检查并经穿刺活检或手术治疗获得病理结果的肝脏局灶性病变患者110例,共134个病变,回顾性分析肝脏良、恶性病变的声像图表现,根据两种检查方法的敏感性、特异性、准确性等,分析比较超声造影对肝脏局灶性病变良、恶性的鉴别诊断价值。结果常规超声和超声造影的敏感性差异无统计学意义(P>0.05),超声造影的准确性及特异性均高于常规超声检查(P<0.05)。常规超声对肝脏局灶病变的诊断结果与病理诊断结果一致性比较的K值为0.51,吻合度一般;超声造影对肝脏局灶性病变的诊断结果与病理诊断结果一致性比较的K值为0.86,吻合度较高。结论超声造影可以根据肝脏局灶性病变的造影剂灌注及消退过程,明显提高对病变良、恶性诊断的特异性及准确率,可作为肝脏局灶病变定性诊断较为重要的依据。

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of liver focal degeneration by retrospectively analyzing the manifestations of liver focal lesions.Methods A total of 110 patients with hepatic focal lesions who received conventional ultrasound and contrast-enhanced ultrasound examination and obtained pathological results by biopsy or surgical treatment in our hospital from September 2019 to September 2021 were selected,with 134 focal liver lesions in total.The ultrasonographic manifestations of benign and malignant liver lesions were retrospectively analyzed,and the differential diagnosis value of contrast-enhanced ultrasound for benign and malignant focal liver lesions was analyzed and compared according to the sensitivity,specificity and accuracy of the two examination methods.Results There was no significant difference in sensitivity between the two methods(P>0.05),and the accuracy and specificity of CUS were higher than that of CUS(P<0.05).The K value of consistency comparison between conventional ultrasound diagnosis results and pathological diagnosis results for liver focal lesions was 0.51,indicating a general degree of coincidence.The K value of contrast ultrasonography for the diagnosis of focal liver lesions was 0.86,indicating a high degree of coincidence.Conclusion Contrast-enhanced ultrasound can significantly improve the specificity and accuracy of benign and malignant diagnosis according to the contrast agent perfusion and regression process of liver focal lesions,which can be used as an important basis for qualitative diagnosis of liver focal lesions.