肝动脉多普勒血流灌注指数与超声造影联合检查肝转移灶的价值

目的 探讨肝动脉多普勒血流灌注指数与超声造影早期联合检查肝转移灶的价值.方法 收集655例非肝恶性肿瘤且术前常规超声检查未发现肝转移性灶的患者,常规超声检查同时行肝动脉多普勒血流灌注指数(DPI)检测,肝动脉DPI升高者再顺序行实时超声造影检查及增强CT检查.所有患者均经手术、超声引导下穿刺活检或随访证实.结果 655例患者中肝动脉DPI未升高562例,随访6个月内发现肝转移灶19例,肝动脉DPI预测肝转移的阴性预测值96.6％(543/562).肝动脉DPI升高(DPI＞30％)93例,6个月内共检出有肝转移者75例,肝动脉DPI预测肝转移的阳性预测值80.6％(75/93).93例肝动脉DPI升高的患者,超声造影检出肝转移者75例,转移灶132枚,增强CT检出肝转移者60例,转移灶94枚,两者比较差异有统计学意义(P＜0.01).结论 联合常规超声检查、肝动脉DPI检测及超声造影检查可显著提高超声对肝转移灶的早期检出率.

Early diagnosis of undiscovered nodosity metastasis by hepatic artery Doppler flow imaging perfusion index and contrast-enhanced ultrasound

Objective To investigate the diagnostic value of early undiscovered nodosity metastasis by hepatic artery Doppler flow imaging perfusion index(DPI) and contrast-enhanced ultrasound (CEUS).Methods Six hundred and fifty-five patients were collected who suffered with malignant tumor which is not from liver and without liver metastasis.DPI were detected in all patients first,and then patients of higher DPI were taken CEUS and contrast-enhanced CT(CECT).All the diagnosis were confirmed by operation,biopsy under ultrasound or follow-up.Results After 6 months' follow-up,there were 19 patients found liver metastasis in 562 patients without increase of DPI,and 75 patients found liver metastasis in 93 patients with increase of DPI(DPI＞30％).The negative and the positive predictive value were respectively 96.6％and 80.6％.Seventy-five patients were found 132 liver metastasis who were given CEUS,and 60 patients were found 94 liver metastasis who were given CECT,there was significance difference between them( P ＜0.01).Conclusions The combination of DPI and CEUS can get higher detection rate of liver metastasis.