超声造影与增强CT诊断胆囊占位性病变的价值分析  

Value of contrast-enhanced ultrasound and enhanced CT in the diagnosis of gallbladder space-occupying lesions

作　　者：张卫军 刘帅兵 呼丹丹 Zhang Weijun;Liu Shuaibing;Hu Dandan(Pingdingshan Hewu General Hospital,Pingdingshan 462500,China)

机构地区：[1]河南省平顶山河舞总医院,462500

出　　处：《中国实用医刊》2022年第3期84-87,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较超声造影与增强CT诊断胆囊占位性病变的临床价值。方法回顾性纳入平顶山河舞总医院2019年3月至2021年2月收治的胆囊占位性病变患者98例,均接受超声造影和增强CT检查。比较超声造影和增强CT诊断胆囊占位性病变的图像特征及诊断效能。结果98例胆囊占位性病变患者经病理活检证实,恶性胆囊占位性病变34例,均为胆囊癌;良性胆囊占位性病变64例。超声造影图像特征显示,病灶增强晚期的增强水平、病灶的形态、胆囊壁完整性和病灶基底状况在诊断良、恶性胆囊占位性病变中的差异有统计学意义(P<0.05)。增强CT图像特征显示,病灶静脉期的增强水平、病灶强化、胆囊壁完整性、病灶基底情况在诊断良、恶性胆囊占位性病变中差异有统计学意义(P<0.05)。超声造影诊断胆囊占位性病变的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为94.12%、96.08%、91.18%、94.23%、93.94%,增强CT分别为92.94%、96.08%、88.24%、92.45%、93.75%,二者与病理诊断均具有较好的一致性(Kappa=0.786、0.732)。结论超声造影和增强CT在鉴别诊断良、恶性胆囊占位性病变中均具有较好的诊断价值和较高的诊断效能,且与病理诊断具有较好的一致性。超声造影和增强CT联合应用可为临床鉴别诊断、恶性胆囊占位性病变提供更全面、有效的影像学数据。Objective To compare the clinical value of contrast-enhanced ultrasound and enhanced CT in the diagnosis of gallbladder space-occupying lesions.Methods Ninety-eight patients with gallbladder space-occupying lesions treated in Pingdingshan Hewu General Hospital from March 2019 to February 2021 were retrospectively included.All of them underwent contrast-enhanced ultrasonography and enhanced CT.The image features and diagnostic efficacy of contrast-enhanced ultrasound and enhanced CT in the diagnosis of gallbladder space-occupying lesions were compared.Results Ninety-eight gallbladder space-occupying lesions were confirmed by pathological biopsy,including 34 cases of malignant gallbladder space-occupying lesions diagnosed as gallbladder cancer,and 64 cases of benign gallbladder space-occupying lesions.The characteristics of contrast-enhanced ultrasound images showed that there were significant differences in the enhancement level,shape,integrity of gallbladder wall and basal condition of lesions in the late stage of lesion enhancement in the diagnosis of benign and malignant gallbladder space occupying lesions(P<0.05).The characteristics of enhanced CT images showed that there were significant differences in the enhancement level,enhancement of lesions,integrity of gallbladder wall and base of lesions in venous phase in the diagnosis of benign and malignant gallbladder space occupying lesions(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of contrast-enhanced ultrasonography in the diagnosis of gallbladder space occupying lesions were 94.12%,96.08%,91.18%,94.23%and 93.94%,respectively,and those of the enhanced CT were 92.94%,96.08%,88.24%,92.45%and 93.75%,respectively,both of the two examination methods were consistent with pathological diagnosis(Kappa=0.786,0.732).Conclusions Contrast-enhanced ultrasound and enhanced CT have good diagnostic value and high diagnostic efficiency in differential diagnosis of benign and malignant gallbladder space-occupying lesions

关 键 词：胆囊 超声造影 增强CT 占位性病变 

分 类 号：R575.6[医药卫生—消化系统]