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目的评价灰阶超声造影对肝脏肿瘤的诊断效能。方法2004年3～8月对114例肝肿瘤病人经外周静脉注射造影剂SonoVue后用对比脉冲序列成像技术行超声造影，依据肿瘤的影像增强特征作出定性诊断，结果与病理或临床确诊标准对照，用诊断性试验评价超声造影的诊断效能。结果超声造影定性诊断肝肿瘤的敏感性、特异性和阳性预测值分别为：肝细胞癌90％(61／68)、93％(43／46)和95％(61／64)；肝内胆管癌为80％(4／5)、98％(97／99)和67％(4／6)；肝转移瘤为86％(12／14)、100％(90／90)和100％(12／12)；肝血管瘤为93％(25／27)、99％(86／87)和96％(25／26)。结论超声造影为临床定性诊断肝脏肿瘤提供了一种准确而简易的新方法。

Characterization of liver tumors with contrast-enhanced ultrasound

Objective To assess the diagnostic performance of contrast-enhanced gray scale ultrasound in characterization of liver tumors. Methods From Mar 2004 to Aug 2004,after intravenous injection of contrast agent SonoVue, contrast-enhanced ultrasound was performed on 114 patients with liver tumors by using the imaging technique of contrast pulse sequence, and the results were compared to pathological or clinical diagnostic criteria. The diagnostic performance was evaluated by using diagnostic test. Results Sensitivity, specificity and positive predictive value in diagnosing liver tumors by using contrast-enhanced ultrasound were as follows: hepatocellular carcinoma, 90%(61/68),93%(43/46)and 95%(61/64), respectively;intrahepatic cholangiocarcinoma,80%(4/5),98%(97/99)and 67%(4/6), respectively;liver metastasis,86%(12/14),100%(90/90)and 100%(12/12), respectively;hepatic hemangioma,93%(25/27),99%(86/87)and 96%(25/26), respectively. Conclusion Contrast-enhanced ultrasound provides a simple and accurate method for characterization of liver tumors.