肝脏实性占位性病变超声造影声像学特征及其诊断价值分析  

Ultrasonographic feature and qualitative diagnosis of intrahepatic solid space-occupying lesions by contrast-enhanced ultrasound

作　　者：李晶晶 范智慧 梅冬雪 张丽[1] 郝玉静 张冬艳[1] Li Jingjing;Fan Zhihui;Mei Dongxue(Department of Ultrasound,Kailuan General Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]开滦总医院超声医学科,河北省唐山市063000 [2]华北理工大学附属医院消化科

出　　处：《实用肝脏病杂志》2025年第2期274-277,共4页Journal of Practical Hepatology

基　　金：河北省卫健委科研计划项目(编号:20210402)。

摘　　要：目的分析肝脏实性占位性病变超声造影声像学特征及其诊断价值。方法2021年3月~2024年3月我院收治的肝脏实性占位性病变患者118例,行常规超声和超声造影(CEUS)检查。所有患者接受外科手术切除肝脏实性占位性病变,以术后组织病理学检查结果为金标准,应用Kappa分析超声造影定性评估肝脏实性占位性病变良恶性与金标准诊断的一致性,构建受试者工作特征(ROC)曲线分析诊断效能。结果在118例肝脏实性占位性病变患者中,术后组织病理学诊断为恶性病变72例,良性病变46例;良性病变造影剂到达时间为(2.5±0.6)s,显著短于恶性病变【(3.6±0.8)s,P<0.05】,达峰时间为(9.5±1.6)s,显著长于恶性病变【(7.3±1.2)s,P<0.05】,峰值强度为(9.4±2.1)dB,显著大于恶性病变【(5.8±0.9)dB,P<0.05】,拟合曲线尖度为(0.4±0.1)l/s,显著小于恶性病变【(1.2±0.3)l/s,P<0.05】;CEUS定性评估与金标准诊断的Kappa值为0.754(P<0.05),一致性较好;CEUS诊断的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为87.5%、89.1%、88.1%、92.7%和82.0%,提示超声造影定性评估的效能较高(P<0.05)。结论超声造影定性评估肝脏实性占位性病变性质具有较高的临床应用价值。Objective The aim of this study was to investigate ultrasonographic feature and qualitative diagnosis of intrahepatic solid space-occupying lesions(SSOL)by contrast-enhanced ultrasound(CEUS).Methods A total of 118 patients with intrahepatic SSOL were encountered in our hospital between March 2021 and March 2024,and all patients underwent CEUS check-up and hepatectomy.The consistency between CEUS and histopathological golden standard in qualitative diagnosis of benign and malignant lesions was analyzed by Kappa.The diagnostic efficacy of CEUS was analyzed by receiver operating characteristic(ROC)curves.Results Of 118 patients with intrahepatic SSOL,histopathological examination found malignant lesions in 72 cases and benign ones in 46 cases;in benign lesions,arrival time was(2.5±0.6)s,much shorter than[(3.6±0.8)s,P<0.05],time to peak was(9.5±1.6)s,much longer than[(7.3±1.2)s,P<0.05],peak intensity was(9.4±2.1)dB,much greater than[(5.8±0.9)dB,P<0.05]and sharpness of fitted curve was(0.4±0.1)l/s,much less than[(1.2±0.3)l/s,P<0.05]in malignant focci;there was a satisfactory consistency between CEUS and golden standard with a Kappa of 0.754(P<0.05);the sensitivity,specificity,accuracy,positive predictive value and negative predictive value by CEUS were 87.5%,89.1%,88.1%,92.7% and 82.0%,suggesting a good diagnostic efficacy(P<0.05).Conclusion The qualitative diagnosis of intrahepatic SSOL by CEUS is efficacious,which might help clinicians make an appropriate measures to deal with as early as possible.

关 键 词：肝脏实性占位性病变 超声造影 声像学特征 诊断 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]