超声造影诊断胆囊实性病变:与常规超声、增强CT/MRI对比  

Contrast-enhanced ultrasonography in diagnosis of gallbladder solid lesions:Comparison on conventional ultrasonography and contrast-enhanced CT/MRI

作　　者：张仲一[1] 吴薇[1] 严昆[1] 杨薇[1] 高文[1] 丛悦[1] 武金玉[2] 陈敏华[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所超声科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]哈尔滨市第一医院超声科,黑龙江哈尔滨150010

出　　处：《中国介入影像与治疗学》2014年第5期302-305,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：首都卫生发展科研专项项目(首发2011-2015-04)

摘　　要：目的评价CEUS鉴别胆囊实性病变良恶性的价值,并与常规超声(US)、增强CT/MRI进行比较。方法回顾性分析49例胆囊实性病变患者的CEUS、US、增强CT/MRI资料,对比不同检查方法对良恶性病变的诊断效能。结果 49例中,胆囊癌32例,胆囊腺瘤局灶恶变2例,胆囊恶性黑色素瘤1例,胆泥3例,胆囊息肉8例,胆囊腺肌症1例,胆囊炎2例;恶性病变共35例,良性病变共14例。US、CEUS与增强CT/MRI诊断胆囊良恶性病变的准确率分别为71.43%、87.75%、89.80%。US与CEUS间(P=0.039)、US与增强CT/MRI间(P=0.020)诊断准确率差异均有统计学意义,CEUS与增强CT/MRI间诊断准确率差异无统计学意义(P=1.000)。不同检查方法间敏感度和特异度差异均无统计学意义(P均>0.05)。结论 CEUS对良恶性病变诊断准确率优于US,与增强CT/MRI相近。Objective To explore the value of CEUS in differentiating benign and malignant gallbladder diseases, and to compare its diagnostic efficacy with conventional ultrasonography （US） and contrast-enhanced CT/MRI. Methods Ima- ging data, including CEUS, US and contrast-enhanced CT/MRI of 49 patients with gallbladder solid lesions were retro- spectively analyzed. The diagnostic efficacy of various methods was compared. Results There were 35 cases of malignant diseases, included gallbladder adenocarcinoma （n= 32）, focal canceration of adenomas （n= 2） and metastatic melanoma （n=1）. Benign lesions were found in other 14 cases, including 3 cases of biliary sludge, 8 cases of cholesterol polyp, 1 case of adenomyomatosis and 2 cases of chronic cholecystitis. The accuracy of US, CEUS and CT/MRI for differentiating of benign and malignant gallbladder diseases was 71.43%, 87.75% and 89. 80%, respectively. There was significant difference between accuracy of US and CEUS （P=0. 039）, US and CT/MRI （P=0. 020）, while there was no significant difference between CEUS and CT/MRI （P=1. 000）. For sensitivity and specificity, no significant difference was found among US, CEUS nor contrast-enhanced CT/MRI （all P〉0.05）. Conclusion The diagnostic accuracy of CEUS for gall- bladder solid lesions is higher than that of US and similar to contrast-enhanced CT/MRI.

关 键 词：胆囊疾病 超声检查 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R730.4[医药卫生—临床医学] R445.2