超声造影引导下经皮肝穿刺活检对肝脏局灶性病变的诊断价值  

Diagnostic value of contrast-enhanced ultrasound guided percutaneous liver biopsy for focal liver lesions

作　　者：闻晶晶 沈海云 孔文韬[1] WEN Jingjing;SHEN Haiyun;KONG Wentao(Department of Ultrasound Diagnosis,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院超声诊断科,南京市210008

出　　处：《临床超声医学杂志》2022年第4期313-315,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声造影引导下经皮肝穿刺活检对肝脏局灶性病变的诊断价值。方法选取我院行经皮肝穿刺活检的肝脏局灶性病变患者354例(共401个病灶),根据引导方法不同分为两组:常规超声组(65例,77个病灶)采用二维超声引导下经皮肝穿刺,超声造影组(289例,324个病灶)采用超声造影引导下经皮肝穿刺。将穿刺结果与临床最终诊断结果进行比较,分析两组肝脏良恶性病灶的诊断准确率。结果常规超声组准确诊断良性病灶16个,恶性病灶50个,总体诊断准确率为85.7%;超声造影组准确诊断良性病灶62个,恶性病灶246个,总体诊断准确率为95.1%,两组比较差异有统计学意义(P=0.003)。超声造影组诊断敏感性和阴性预测值均高于常规超声组(95.3%vs.84.7%,83.8%vs.64.0%),差异均有统计学意义(P=0.008、0.036)。对于直径≤2.0 cm的病灶,超声造影组诊断准确率高于常规超声组(96.3%vs.74.1%),差异有统计学意义(P=0.009)。结论超声造影引导下经皮肝穿刺活检对肝脏局灶性病变的良恶性鉴别诊断有重要的价值,尤其对于直径≤2.0 cm的病灶更具诊断优势。Objective To explore the diagnostic value of contrast-enhanced ultrasound(CEUS)guided percutaneous liver biopsy for focal liver lesions.Methods A total of 354 patients(401 lesions)who underwent percutaneous liver biopsy in our hospital were selected.According to different guidance methods,the patients were divided into two groups:conventional ultrasound group(65 cases,77 lesions)underwent two-dimensional ultrasound-guided percutaneous liver puncture,and CEUS group(289 cases,324 lesions)underwent CEUS guided percutaneous liver puncture.The biopsy results was compared with the final clinical diagnosis results,and the diagnostic accuracy of benign and malignant liver lesions in the two groups were analyzed.Results In the conventional ultrasound group,16 benign lesions and 50 malignant lesions were accurately diagnosed,with a diagnostic accuracy of 85.7%.In the CEUS group,62 benign lesions and 246 malignant lesions were accurately diagnosed,with a diagnostic accuracy of 95.1%.There was statistically significant difference between the two groups(P=0.003).The diagnostic sensitivity and negative predictive value of CEUS group were higher than those of conventional ultrasound group(95.3%vs.84.7%,83.8%vs.64.0%),and the differences were statistically significant(P=0.008,0.036).For lesions with diameter≤2.0 cm,the diagnostic accuracy of CEUS group was higher than that of conventional ultrasound group(96.3%vs.74.1%),the difference was statistically significant(P=0.009).Conclusion CEUS guided percutaneous liver biopsy is of great value in the differential diagnosis of benign and malignant focal liver lesions,especially for lesions with diameter≤2.0 cm.

关 键 词：超声检查 造影剂 肝穿刺活检 经皮 肝脏局灶性病变 良恶性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]