| 摘要: |
| 【摘要】 目的 探讨超声造影及定量分析对延迟相廓清的肝炎性病灶的鉴别诊断价值。 方法 对38例经手术或穿刺活检病理证实为肝炎性病灶的患者共38个病灶进行常规超声、超声造影检查（CEUS）及超声造影定量分析，并与同期行CEUS检查的66个HCC病灶进行比较。 结果 肝炎性病灶组和HCC组之间的性别、症状、CA125、AFP和乙型肝炎病毒感染史等临床特征存在差异（P <0.05）。CEUS特征分析，肝炎性病灶与HCC相比，强化的形态不规则，边界不清（P <0.01）；肝炎性病灶与HCC相比，门脉相增强强度低增强：等增强：高增强比例为30:8:0 vs26:34:6，门脉期增强程度存在显著差异，差异具有统计学意义（P <0.01）。CEUS定量分析显示肝炎性病灶的增强曲线下面积（AUC）显着大于HCC（p <0.01）；肝炎性病灶的下降时间与平均通行时间比HCC更短（p <0.05）。在CEUS定量分析中，显示出统计学意义的单变量区分肝炎性病灶与HCC的敏感性和特异性分别为92.4-100.0％和68.2-73.7％。变量纳入logistic回归分析后,在鉴别肝炎性病灶和HCC的定量分析中，增强AUC> 365.281有助于正确诊断肝炎性病灶。结论 CEUS为延迟相廓清的肝炎性病灶与HCC的鉴别诊断可提供重要信息，CEUS定量分析可更客观地显示肝脏炎性病灶的血流灌注特征，对延迟相廓清的肝炎性病灶具有较好的临床应用价值。 |
| 关键词: 超声检查 造影剂 肝疾病 诊断 |
| DOI： |
| 投稿时间：2020-03-31修订日期：2020-12-09 |
| 基金项目: |
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| Differentiation diagnosis of delayed phase clearancing liver inflammatory lesions and hepatocellar carcinoma with contrast enhanced ultrasoundHuang Zhe, Zhou PingPing, Wu Xiaobei, Li ShanShan, Luo HongChang, Li Kaiyan. Department of Ultrasound,Tongji Hospital,Tongji Medical College ,Huazhong University of Science and Technology,Wuha 430030,China |
| huangzhe,Zhou PingPing,Wu XiaoBei,Li ShanShan,Luo HongChang,Li KaiYan |
| (Department of Ultrasound,Tongji Hospital,Tongji Medical College ,Huazhong University of Science and Technology) |
| Abstract: |
| 【Abstract】 Objective To explore the value of quantitative analysis of contrast ultrasound in the differential diagnosis of delayed-phase clearance of liver inflammatory lesions. Method A total of 38 patients with hepatic inflammatory lesions confirmed by surgery or biopsy were subjected to conventional ultrasound, contrast-enhanced ultrasound (CEUS) and quantitative analysis of contrast ultrasound, and compared with HCC lesions performed at the same time. Result There were differences in clinical characteristics such as gender, symptoms, history of CA125, AFP, and hepatitis B virus infection between the hepatitis lesion group and the HCC group (P <0.05). CEUS feature analysis showed that compared with HCC, the enhanced morphology of the hepatitis lesions was irregular and the borders were unclear (P <0.01); compared with HCC, the enhancement intensity of portal phase was low for the hepatitis lesions; : 8: 0 vs26: 34: 6, there is a significant difference in the degree of portal phase enhancement, the difference is statistically significant (P <0.01). CEUS quantitative analysis showed that the area under the enhancement curve (AUC) of hepatitis lesions was significantly greater than that of HCC (P <0.01); the decline time and average transit time of hepatitis lesions were shorter than HCC (P <0.05). In the CEUS quantitative analysis, the sensitivity and specificity of the statistically significant univariate distinction between hepatitis lesions and HCC were 92.4-100.0% and 68.2-73.7%, respectively. After the variables were included in the logistic regression analysis, in the quantitative analysis of identifying hepatic lesions and HCC, enhancing AUC> 365.281 may help to correctly diagnose hepatic lesions. Conclusion CEUS provides important information for the differential diagnosis of hepatic lesions and HCC with delayed phase clearance. Quantitative analysis of CEUS can more objectively show the characteristics of blood perfusion of hepatic inflammatory lesions, and has good clinical application value. |
| Key words: Ultrasonography Contrast agent Liver disease Diagnosis |
