低频超声联合高频超声在胆囊息肉样病变性质中的诊断价值

The Diagnostic Value of Low-Frequency Ultrasound Combined with High-Frequency Ultrasound in the Nature of Gallbladder Polypoid Lesions

目的:探讨低频超声联合高频超声在胆囊息肉样病变性质中的诊断价值。方法:选取2019年1月~2021年12月于本院就诊的63例胆囊息肉样病变患者作为研究对象,所有患者均在本院采用低频超声与高频超声进行检测,根据手术及病理组织检查结果分析对比经低频超声检测以及两种超声方法联合检测对胆囊息肉样病变性质的诊断价值。结果:胆囊息肉样良性病变患者无血流信号、与囊壁分解不清晰、胆囊壁不连续、病灶基底较宽的人数比例低于恶性病变患者(P<0.05)。低频超声检查、低频联合高频超声检查的Kappa值分别为0.455、0.930,(P<0.05),其中低频超声检查的Kappa值在0.4~0.75范围内,说明诊断一致性一般,而低频联合高频超声检查的Kappa值>0.75,说明诊断一致性较好。联合检测对胆囊息肉样良性病变的敏感度、特异度、准确度为95.24%、100.00%、96.83%,均处于较高水平,高于低频超声检查;联合检查的ROC曲线下面积为0.853,高于低频超声检查的ROC曲线下面积(AUC=0.612)。结论:低频联合高频超声检查对胆囊息肉样病变的诊断结果与手术或病理组织结果具有良好一致性,对胆囊息肉样良性病变有着较高的诊断效能,是鉴别胆囊息肉样病变性质的有效方法之一。

Objective:To investigate the diagnostic value of low frequency ultrasound combined with high frequency ultrasound in the characteristics of polypoid lesions of gallbladder.Methods:63 patients with gallbladder polypoid lesions admitted to our hospital from January 2019 to December 2021 were selected as research objects.All patients were detected by low frequency ultrasound and high frequency ultrasound in our hospital.According to the results of operation and pathological examination,the diagnostic value of low frequency ultrasound detection and the combined detection of two ultrasonic methods in the nature of gallbladder polypoid lesions was analyzed and compared.Results:The proportion of patients with benign gallbladder polypoid lesions with no blood flow signal,unclear decomposition of cystic wall,discontinuous gallbladder wall and wider focal base was lower than those with malignant lesions(P<0.05).Kappa values of low-frequency ultrasound and low-frequency combined high-frequency ultrasound were 0.455 and 0.930,respectively(P<0.05),among which Kappa values of low-frequency ultrasound were within the range of 0.4-0.75,indicating general consistency of diagnosis,while Kappa values of low-frequency combined high-frequency ultrasound were greater than 0.75.The diagnosis consistency is good.The sensitivity,specificity and accuracy of combined detection for benign polypoid lesions of gallbladder were 95.24%,100.00%and 96.83%,which were all at a higher level than that of low-frequency ultrasound.The area under ROC curve of combined examination was 0.853,which was higher than that of low-frequency ultrasound examination(AUC=0.612).Conclusion:The diagnostic results of low frequency combined with high frequency ultrasound for gallbladder polypoid lesions are in good agreement with the results of surgery or pathological tissue.It has high diagnostic efficacy for gallbladder polypoid benign lesions,and is one of the effective methods to distinguish the nature of gallbladder polypoid lesions.