实时超声造影与增强螺旋CT对直径<3cm肝占位病变的诊断价值比较  

Comparisonon the clinical value of real-time contrast-enhanced ultrasonography and contrast-enhanced CT in diagnosis of focal liver lesions less than 3 cm

作　　者：冯念 徐捷 唐胜滢 黄艳丽 FENG Nian;XU Jie;TANG Sheng-ying;HUANG Yan-li(Department of Special Diagnosis,Qinhuai Medical Treatment Area of General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院秦淮医疗区特诊科,南京210002

出　　处：《东南国防医药》2021年第5期501-505,共5页Military Medical Journal of Southeast China

摘　　要：目的比较实时超声造影与增强螺旋CT在诊断直径<3cm的肝占位性病变中的诊断价值。方法回顾性分析东部战区总医院秦淮医疗区2017年1月到2020年1月290例肝占位性病变患者的影像资料,观察比较同一病灶在超声造影和增强螺旋CT检查下的诊断结果,并与手术病理结果比较,分析超声造影和增强螺旋CT诊断的特异性、灵敏性和准确性。结果对于直径<3 cm的肝占位病变,实时超声造影的特异性98.64%、灵敏性97.20%、准确性97.93%,增强螺旋CT检查的特异性92.52%、灵敏性88.81%、准确性90.69%,差异均有统计学意义(P<0.05)。实时超声造影ROC曲线下面积(AUC)为0.978,标准误为0.045,增强螺旋CT的ROC曲线下面积(AUC)为0.813,标准误为0.067,差异有统计学意义(P<0.05)。实时超声造影检查肝恶性占位病变的平均通过时间、上升时间、达峰时间明显少于良性病变(P<0.01),灌注指数明显大于良性病变(P<0.01)。结论在直径<3 cm肝占位病变的诊断中,实时超声造影的特异性、灵敏性、准确性比增强螺旋CT更高,具有临床应用价值。Objective To compare the clinical value of real-time contrast-enhanced ultrasound and enhanced spiral CT in diagnosis focal liver lesions less than 3 cm.Methods A total of 290 patients with focal liver lesions less than 3 cm were enrolled in this study from January 2017 to January 2020.The diagnosis results of the contrast-enhanced ultrasound and enhanced spiral CT were observed and compared retrospectively.The accuracy,sensitivity and specificity of contrast-enhanced ultrasonography and enhanced spiral CT were analyzed compared with the results of surgery and pathology.Results For the focal liver lesions less than 3 cm,the specificity,sensitivity,and accuracy of real-time contrast-enhanced ultrasound was 98.64%,97.20%,and 97.93%,respectively.The specificity,sensitivity,and accuracy of enhanced spiral CT was 92.52%,88.81%,and 90.69%,respectively.There were significant differences between the two groups(P<0.05).The area under the ROC curve of real-time contrast-enhanced ultrasound was 0.978 and the standard error was 0.045.The area under the ROC curve of enhanced spiral CT was 0.813 and the standard error was 0.067(P<0.05).In real-time contrast-enhanced ultrasound examination,the average transit time,rise time,and peak time of malignant focal liver lesions were less than benign lesions(P<0.05),and the perfusion index was greater than benign(P<0.05).Conclusion For the focal liver lesions less than 3 cm,real-time contrast-enhanced ultrasound has higher specificity,sensitivity and accuracy than enhanced spiral CT,which has clinical value.

关 键 词：实时超声造影 增强螺旋CT 肝占位病变 

分 类 号：R445.1[医药卫生—影像医学与核医学]