摘要
目的分析实时超声造影对肝硬化伴占位性病变的血流灌注特征，探讨良恶性占位病变的诊断和鉴别诊断价值。方法对经病理证实的78例肝硬化患者中102个病灶，采用低机械指数（MI0.06-0.10）反向脉冲谐波造影成像技术进行实时超声造影观察，并与常规彩超和增强CT对照分析。结果超声造影、增强CT、常规彩超诊断肝癌的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为97.8%、93.9%、95.7%、96.9%、96.2%和93.3%、93.9%、95.5%、91.2%、93.6%以及60%、66.7%、71.1%、55%、62.8%。本组资料表明，超声造影、增强CT与病理诊断具有很高的一致性（Kappa值分别为0.93、0.87），明显高于常规彩超（Kappa值为0.26）。结论超声造影对肝硬化背景下再生结节与原发性肝癌的诊断和鉴别诊断具有重要的临床价值。
Objective To analyze characteristics of blood flow perfusion in the focal hepatic lesions using real-time contrast-enhanced ultrasound （CEUS） and investigate the clinical value of CEUS in the differential diagnosis of cirrhosis with nodus. Methods 102 lesions in 78 patients with liver cirrhosis confirmed by pathology were observed using low mechanical index （MI 0.06-0. 10） pulse- inversion harmonic sonography. The characteristics of blood flow perfusion in lesions were analyzed and compared with common color Doppler sonography and contrast-enhanced CT. Results The sensitivity, specificity, positive and negative predict value, accuracy rates in diagnosing primary hepatic carcinoma by CEUS, contrast-enhanced CT and common color Doppler sonography were 97.8%, 93.9%, 95.7%, 96.9% 96.2%.and 93.3%, 93.9%, 95.5%, 91.2%, 93.6% and 60%, 66.7%, 71.1%, 55%, 62.8% respectively. The data form CEUS and contrast-enhanced CT were highly consistent with results of pathology （Kappa ： 0.93 and 0.87）, and their correct rate of diagnosis were significantly higher than those of common color ultrasound （Kappa ： 0.26 ）. Conclusion There is an important clinical practical value for using real-time CEUS to differential diagnose primary hepatic carcinoma and hepatic cirrhosis nodus.
出处
《东南国防医药》
2009年第2期121-123,共3页
Military Medical Journal of Southeast China
关键词
原发性肝癌
肝硬化
再生结节
超声造影
Primary hepatic carcinoma
Heptic cirrhosis
Cirrhosis nodus
Contrast-enhanced ultrasonography
