超声造影与增强CT对胆囊占位病变良恶性的鉴别诊断对比分析  

Comparative analysis of contrast-enhanced ultrasound and contrast-enhanced CT in differential diagnosis of benign and malignant space-occupying lesions of gallbladder

作　　者：李洁 吴荣秀[2] 俞天智[3] Li Jie;Wu Rongxiu;Yu Tianzhi(Department of Ultrasound,Binhai Hospital of Tianjin Medical University General Hospital,Tianjin 300480,Chin;Health Management Center,Tianjin Medical University General Hospital,Tianjin 300052,China;Medical Department,Tianjin Medical University General Hospital,Tianiin 300052,China)

机构地区：[1]天津医科大学总医院滨海医院超声科,300480 [2]天津医科大学总医院健康管理中心,300052 [3]天津医科大学总医院医务处,300052

出　　处：《国际生物医学工程杂志》2018年第3期261-264,270,共5页International Journal of Biomedical Engineering

摘　　要：目的 对比超声造影（CEUS）和增强CT（CECT）在胆囊占位病变良恶性鉴别诊断中的效能.方法 回顾性分析68例经手术及穿刺病理证实的胆囊占位病变临床资料,对比分析CEUS和CECT的诊断准确率、敏感度和特异度.结果 在总共68例病理资料中,31例为良性胆囊占位病变,37例为恶性病变（胆囊癌）.对于良性占位病变,CEUS和CECT在增强早期均以高增强为主,分别为90.3％和83.9％;增强晚期则多为低增强,分别为93.5％和87.1％.对于胆囊癌恶性病变,CEUS和CECT在增强早期以高增强为主,分别为94.6％和89.2％;增强晚期均为低增强.在良性与恶性胆囊占位病变鉴别诊断中,CEUS的达峰时间、消退时间、峰值强度和平均渡越时间的差异均具有统计学意义（均P＜0.01）.良性占位病变中,CEUS和CECT显示不均匀增强者分别为41.9％和48.4％;而对于胆囊癌,不均匀增强者分别为94.6％和91.9％,胆囊壁不完整者分别为89.2％和91.9％,但其差异均无统计学意义（均P＞0.05）.CEUS和CECT的病变良恶性诊断准确率分别为92.6％和89.7％,敏感性为93.5％和90.3％,特异性为89.2％和83.8％,但其差异无统计学意义（均P＞0.05）.结论 CEUS和CECT对胆囊占位病变的良恶性鉴别诊断效能相当,但CEUS较CECT更具优势,值得临床广泛应用及推广.Objective To compare the efficacy of contrast-enhanced ultrasound （CEUS） and enhanced CT （CECT） in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.Methods The clinical data of 68 cases of space-occupying lesions of gallbladder confirmed by surgery and biopsy were retrospectively analyzed.The diagnostic accuracy,sensitivity and specificity of CEUS and CECT were analyzed and compared.Results In a total of 68 cases of space-occupying lesions of gallbladder,31 cases were benign lesions and 37 were malignant lesions （gallbladder cancer）.For the benign lesions cases,CEUS and CECT were mainly hyper-enhanced in the early stage of enhancement,which were 90.3% and 83.9%,respectively.In the late stage of enhancement,they were mostly low-enhanced,which were 93.5% and 87.1%,respectively.For the gallbladder cancer cases,CEUS and CECT were predominantly hyper-enhanced in the early stage of enhancement,which were 94.6% and 89.2%,respectively,and were all low-enhanced in the late stage of enhancement.In the differential diagnosis for benign and malignant space-occupying gallbladder lesions by CEUS,the differences in peak time,extinction time,peak intensity and average transit time were statistically significant （all P〈0.01）.The inhomogeneous enhancement rates were 41.9% and 48.4% respectively for CEUS and CECT in the benign lesions cases,and 94.6% and 91.9% in the gallbladder cancer cases.Besides,the incomplete gallbladder wall rates are 89.2% and 91.9% in the gallbladder cancer cases.However,these differences were all not statistically significant （all P〉0.05）.In the diagnosis of benign and malignant lesions cases,the diagnostic accuracy of CEUS and CECT were 92.6% and 89.7%,the sensitivity was 93.5% and 90.3%,and the specificity was 89.2% and 83.8%,respectively,but the differences were not statistically significant （all P〉0.05）.Conclusion CEUS and CECT have comparable efficacy in differential diagnosis of benign and malignant space-occupying lesions of gallblad

关 键 词：超声造影 增强CT 胆囊肿瘤 

分 类 号：R735.8[医药卫生—肿瘤] R445.1[医药卫生—临床医学] R730.44