超声造影在肝内占位病变鉴别诊断中的应用价值

Application value of ontrast-enhanced ultrasound in the differential diagnosis of intrahepatic spaceoccupying lesions

目的探究超声造影(CEUS)在肝内占位病变鉴别诊断中的应用价值。方法回顾性分析2019年5月至2021年8月于萍乡市人民医院检查的84例肝内占位病变患者的临床资料,所有患者均实施彩色多普勒超声、CEUS和术后病理检查,以术后病理检查结果为金标准,分析彩色多普勒超声、CEUS鉴别诊断价值,计算并比较彩色多普勒超声、CEUS鉴别诊断肝内占位病变的灵敏度、特异度、准确度。结果彩色多普勒超声诊断肝内占位病变的灵敏度为86.89%(53/61),特异度为82.61%(19/23),准确度为85.71%(72/84),阳性预测值为92.98%(53/57),阴性预测值为90.37%(19/27),Kappa值为0.659;CEUS诊断肝内占位病变灵敏度为98.36%(60/61),特异度为91.30%(21/23),准确度为96.43%(81/84),阳性预测值为96.77%(60/62),阴性预测值为95.45%(21/22),Kappa值为0.909;CEUS诊断灵敏度、准确度均高于彩色多普勒超声,差异有统计学意义(P<0.05);CEUS和彩色多普勒超声诊断特异度比较差异无统计学意义。结论CEUS鉴别诊断肝内占位病变的灵敏度、准确度均明显高于彩色多普勒超声,可为临床诊断提供依据。

Objective To explore the applicationvalue of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of intrahepatic spaceoccupying lesions.Methods The clinical data of 84 patients with intrahepatic space-occupying lesions examined in Pingxiang People’s Hospital between May 2019 and August 2021 were retrospectively analyzed,all patients underwent color Doppler ultrasound,CEUS and postoperative pathological examination,with postoperative pathological examination results as the gold standard,the differential diagnostic value of color Doppler ultrasound and CEUS was analyzed,and the sensitivity,specificity and accuracy of color Doppler ultrasound and CEUS for differential diagnosis of intrahepatic space-occupying lesionswere calculated and compared.Results The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value were 86.89%(53/61),82.61%(19/23),85.71%(72/84),92.98%(53/57),90.37%(19/27)and 0.659 of color Doppler ultrasound,and were 98.36%(60/61),91.30%(21/23),96.43%(81/84),96.77%(60/62),95.45%(21/22)and 0.909 of CEUS in the diagnosis of intrahepatic space-occupying lesions.The sensitivity and accuracy of CEUS diagnosis were higher than those of color Doppler ultrasound diagnosis(P<0.05).There was no statistical significance in specificity between CEUS and color Doppler ultrasound.Conclusion The sensitivity and accuracy of CEUS in the differential diagnosis of intrahepatic space-occupying lesions are significantly higher than those of color Doppler ultrasound,and can provide a basis for clinical diagnosis.