摘要
目的比较常规超声和超声造影鉴别肝局灶性小病变的诊断性能。方法对200个直径≤3.0cm的肝局灶性病变行常规超声和实时超声造影检查。超声造影采用六氟化硫气体微泡造影剂和对比脉冲序列成像技术。两位超声医师(受试者)对检查结果独立作出诊断,用受试者工作特征曲线评估常规超声和超声造影对病变的鉴别诊断性能,Kappa值评估受试者之间的一致性。结果受试者工作特征曲线显示两位受试者得到的曲线下面积常规超声分别为0.856和0.857,超声造影分别为0.954和0.943(P<0.001和P=0.003)。超声造影能显著提高判别病变良恶性的敏感性、阴性预测值和准确性(均P<0.001)。受试者之间的一致性超声造影较常规超声高,κ值分别为0.716和0.425。两位受试者对具体病变的诊断正确率常规超声分别为38.5%(77/200)和34.5%(69/200),超声造影分别为80.5%(161/200)和80.5%(161/200)(均P<0.001)。结论实时超声造影可显著提高对肝局灶性小病变的鉴别诊断能力。
Objective To assess the diagnostic performance of real-time contrast-enhanced ultrasound in characterization of small focal liver lesions in comparison with baseline ultrasound. Methods Two hundred small focal liver lesions （43.0 cm in diameter） in 200 patients were examined by real-time contrast-enhanced ultrasound mode of contrast pulse sequencing with a sulphur hexafluoride-filled microbubble contrast agent. Two independent investigators reviewed the images before and after contrast agent administration. The diagnostic performances were evaluated using receiver operating characteristic （ROC） analysis and the interobserver agreement was analyzed. Results After review of contrast-enhanced ultrasound, ROC analysis revealed significant improvement in differentiating between malignant and benign small focal liver lesions that the areas under the ROC curve were 0. 856 and 0. 857 at baseline ultrasound versus 0. 954 and 0. 943 at contrast-enhanced ultrasound （ P 〈0. 001 and P = 0. 003 ）. The sensitivity, negative predictive value and accuracy for both investigators also improved significantly after reviewing contrast-enhanced ultrasound （all P 〈0. 001 ）. A better interobserver agreement was achieved after reviewing of contrast-enhanced ultrasound （κ = 0. 425 at baseline ultrasound versus κ = 0. 716 at contrast-enhanced ultrasound） and a better result of specific diagnosis was obtained [38.5 % （77/200） and 34. 5 （69/200） at baseline ultrasound versus 80.5% （161/200） and 80.5% （161/200） at contrast-enhanced ultrasound] （all P 〈 0. 001 ）. Conclusions Real-time contrast-enhanced ultrasound improves the diagnostic performance in small focal liver lesions for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.
出处
《中华超声影像学杂志》
CSCD
2006年第8期584-587,共4页
Chinese Journal of Ultrasonography
基金
广东省科委重点攻关项目资助(2002C31108)
关键词
超声检查
造影剂
肝疾病
ROC曲线
Ultrasonography
Contrast media
Liver diseases
ROC curve
