CEUS联合常规US在厚壁型胆囊病变、胆囊息肉样病变诊断中的应用

Application of CEUS Combined with Conventional US in the Diagnosis of Thick-walled Gallbladder Lesions and Gallbladder Polypoid Lesions

本文探讨超声造影(CEUS)联合常规超声(US)在厚壁型胆囊病变、胆囊息肉样病变诊断中的价值。选择46例厚壁型胆囊病变患者和60例胆囊息肉样病变患者,分析患者临床资料、CEUS及US影像特征差异,分析CEUS联合常规US的诊断价值。厚壁型胆囊恶性病变患者胆囊壁厚度、胆囊内壁和外壁不连续比例、高增强比例高于良性病变(P<0.05),而始增时间和消退时间快于良性病变(P<0.05)。胆囊息肉样恶性病变患者病变有血流、与囊壁分界不清晰、胆囊壁不连续比例高于良性病变患者(P<0.05),而始增时间和消退时间快于良性病变(P<0.05)。CEUS联合常规US诊断厚壁型胆囊良恶性病变与病理结果Kappa值为0.870(P<0.05),一致性较高,诊断恶性病变灵敏性、特异性和准确性分别为91.67%、95.45%和93.48%。CEUS联合常规US诊断胆囊息肉样良恶性病变与病理结果Kappa值为0.832(P<0.05),一致性较高,诊断恶性病变灵敏性、特异性和准确性分别为90.91%、92.59%和91.67%。CEUS联合常规US在厚壁型胆囊良恶性病变、胆囊息肉样良恶性病变诊断中有较好的应用价值。

This article discussed the value of contrast-enhanced ultrasonography(CEUS)combined with conventional ultrasonography(US)in the diagnosis of thick-walled gallbladder lesions and gallbladder polypoid lesions.Forty-six patients with thick-walled gallbladder lesions and 60 patients with gallbladder polypoid lesions were selected.The clinical data,CEUS and US imaging features of patients were analyzed,and the diagnostic value of CEUS combined with conventional US was analyzed.The thickness of gallbladder wall,the proportion of discontinuous inner and outer gallbladder walls,and the proportion of high enhancement in patients with thick-walled gallbladder malignant lesions were higher than those in benign lesions(P<0.05),while the onset time and resolution time were faster than those in benign lesions(P<0.05).The patients with malignant gallbladder polypoid lesions had blood flow,unclear boundary with the cyst wall,and the proportion of gallbladder wall discontinuity was higher than that of benign lesions(P<0.05),and the time of onset and regression was faster than that of benign lesions(P<0.05).The Kappa value of CEUS combined with conventional US in the diagnosis of benign and malignant thick-walled gallbladder lesions was 0.870(P<0.05),and the consistency was high.The sensitivity,specificity and accuracy of diagnosing malignant lesions were 91.67%,95.45%and 93.48%,respectively.The Kappa value of CEUS combined with conventional US in the diagnosis of benign and malignant gallbladder polypoid lesions and pathological results was 0.832(P<0.05),and the consistency was high.The sensitivity,specificity and accuracy of diagnosing malignant lesions were 90.91%,92.59%and 91.67%,respectively.CEUS combined with conventional US has good application value in the diagnosis of benign and malignant thick-walled gallbladder lesions and benign and malignant gallbladder polypoid lesions.