动态三维超声造影联合剪切波弹性成像对肝脏局灶性病变良恶性的诊断价值  

Diagnostic Value of Dynamic Three-Dimensional Contrast-Enhanced Ultrasound Combined with Shear-Wave Elastography in Benign and Malignant Focal Liver Lesions

作　　者：曲美景 许预 周春霞[1] 崔岩[1] 刘妍 朱芸佩 王辉[1] Qu Meijing;Xu Yu;Zhou Chunxia;Cui Yan;Liu Yan;Zhu Yunpei;Wang Hui(Department of Ultrasound,The First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning 116600,China)

机构地区：[1]大连医科大学附属第一医院超声科,辽宁省大连市116600

出　　处：《中国超声医学杂志》2024年第5期551-554,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨动态三维超声造影(3D-CEUS)和剪切波弹性成像(SWE)指标独立诊断及联合诊断肝脏局灶性病变(FLLs)的价值。方法收集并分析FLLs患者共82个病灶的资料,以病理或两种及以上增强影像学检查一致作为确诊标准将所有病灶分为良性和恶性组。测量病灶平均杨氏模量值(Emean),记录病灶动态3D-CEUS的造影剂灌注情况、血管数量及特点,计算造影前后病灶体积变化率。构建受试者工作特征(ROC)曲线,分析SWE、动态3D-CEUS及二者联合诊断FLLs良恶性的价值。结果恶性与良性组病灶在Emean值、造影剂灌注情况、血管数量及特点、造影前后病灶体积变化率之间差异具有统计学意义(P<0.05);SWE、动态3D-CEUS及二者联合评估FLLs良恶性的ROC曲线下面积(AUC)分别是0.896、0.974、0.999,行Kappa一致性检验分析,两种方法联合诊断FLLs良恶性的效能高于二者独立诊断(P<0.05)。结论SWE、动态3D-CEUS及联合诊断对鉴别FLLs良恶性均具有一定临床价值,动态3D-CEUS联合SWE诊断临床价值最高。Objective To evaluate the value of independent and combined indexes of dynamic three-dimensional contrast-enhanced ultrasound(3D-CEUS)and shear-wave elastography(SWE)in the diagnosis of benign and malignant focal liver lesions(FLLs).Methods A total of 82 lesions were classified into benign and malignant groups according to the diagnosis criteria of pathology or two or more enhanced imaging examinations.Measuring the mean Young's modulus(Emean),recording the contrast agent perfusion,number and characteristics of blood vessels in dynamic 3D-CEUS.Calculating the pre-and post-contrast volume change rate of the lesion.The receiver operating characteristic(ROC)curve was constructed to analyze the diagnostic value of SWE,dynamic 3D-CEUS and their combination in the diagnosis of benign and malignant FLLs.Results There were statistically significant differences between malignant and benign lesions in mean Young's modulus,contrast agent perfusion,number and characteristics of vessels,and pre-and post-contrast volume change rate(P<0.05).The the area under the ROC curve(AUC)of SWE,dynamic 3D-CEUS and their combined diagnostic evaluation of FLLs were 0.896,0.974 and 0.999.The Kappa consistency test was employed for analysis,the combined use of the two methods demonstrated a higher diagnostic efficacy for FLLs compared to using each method alone(P<0.05).Conclusions SWE,dynamic 3D-CEUS and their combined diagnosis have certain clinical value in differentiating benign and malignant FLLs,and dynamic 3D-CEUS combined with SWE has the highest clinical value.

关 键 词：三维超声造影 肝脏局灶性病变 剪切波弹性成像 

分 类 号：R73[医药卫生—肿瘤]