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1.
目的:进一步研究超声造影在肝脏局灶性病变良恶性鉴别诊断中的价值.方法:选取肝局灶性病变患者262例为研究对象,行常规超声和超声造影检查,并与病理结果做对比.结果:常规超声及超声造影诊断肝脏局灶性病变良恶性的敏感性、特异性、阳性预测值、阴性预测值、诊断符合率分别为88.8%、75.2%、76.6%、88.0%、81.7%及99.2%、98.5%、98.4%、99.3%、98.8%,二者比较差异有统计学意义(P0.05).超声造影与病理诊断一致性较好(Kappa=0.976).结论:超声造影提高了对肝脏局灶性病变的定性诊断能力,具有重要临床价值.  相似文献   

2.
目的 探究超声造影在肝脏局灶性病变鉴别诊断中的临床应用效果.方法 我院经超声造影诊断为肝脏局灶性病变的患者中,选取64例作为此次调查的对象,术前超声发现93个病灶,按照病例的结果 ,比较超声造影与病例结果 的符合率.结果 经过穿刺活检,或者手术切除后的病理检查结果 显示,良性病灶31个,恶性病灶62个.其中,常规超声检查:良性病灶25个,符合率为80.64%,恶性病灶32个,符合率为51.61%;敏感性为56.14%,特异性为44.64%.而超声造影检查:良性病灶27个,符合率为87.09%,恶性病灶59个,符合率为95.16%;敏感性为92.18%,特异性为90.0%.结论 对于肝脏局灶性病变鉴别诊断中,超声造影能够提供准确可靠的依据,且敏感性和特异性较高,值得推广.  相似文献   

3.
目的 探讨超声弹性成像5分法在肝脏局灶良、恶性病变中的诊断价值。方法 本院2013年8月至2016年2月收治的78例肝脏局灶性良、恶性病变患者,采用常规超声检查和超声弹性成像5分法评定肝脏局灶性病变性质,以手术组织病理学检查为金标准,比较两种超声检查方法的诊断效能。结果 在78例肝脏局灶性病灶患者,经病理学检查诊断为恶性病灶54例,其中胆管细胞癌4例,转移性肝癌11例,肝细胞癌39例,诊断为良性病灶24例,其中肝局灶性结节性增生4例,肝血管瘤9例,肝脓肿11例;常规超声检查诊断恶性病变的灵敏度为75.9%(41/54),诊断良性病变的特异度为75.0%(18/24),准确度为75.6%(59/78),阳性预测值为87.2%(41/47),阴性预测值为58.1%(18/31);弹性成像5 分法诊断恶性病变的灵敏度为98.1%(53/54),诊断良性病变的特异度为79.2%(19/24),准确度为92.3%(72/78),阳性预测值为91.4%(53/58),阴性预测值为95.0%(19/20)。与常规超声检查比,弹性成像的诊断效能较高,差异具有统计学意义(x2=8.050,P=0.005)。结论 在鉴别诊断肝脏局灶性病变性质方面,超声弹性成像5分法比常规超声检查更灵敏和更准确,具有极大的临床应用价值。  相似文献   

4.
目的探讨超声弹性成像对老年肝脏局灶性病变的诊断价值。方法选择疑似肝脏局灶性病变老年患者127例(144个病灶),术前或病变穿刺前均行常规超声检查及超声弹性成像,然后手术取出病灶或穿刺病灶行病理检查。以病理结果为金标准,观察常规超声检查及超声弹性成像诊断与病理结果的一致性,比较常规超声检查及超声弹性成像诊断肝脏恶性肿瘤的敏感性、特异性、准确性。结果 144个病灶经手术或穿刺病理检查共发现肝脏恶性病灶86个,良性病灶58个。常规超声检查诊断恶性病灶78个,良性病灶66个,其诊断与病理检查结果基本一致(Kappa=0.686)。超声弹性成像检查发现恶性肿块81个,良性病灶63个。其诊断与病理检查结果高度一致(Kappa=0.865)。超声弹性成像诊断肝脏恶性肿瘤敏感性、特异性、准确性分别为86.0%、87.9%、86.8%,常规超声检查分别为72.1%、72.4%、72.2%;两者比较差异均有统计学意义(P均<0.05)。结论超声弹性成像对老年肝脏局灶性病变的诊断有重要价值。  相似文献   

5.
目的 探讨超声弹性成像与超声造影(CUES)对肝脏占位性病变性质的鉴别诊断价值。方法 2015年1月~2016年12月我院诊治的肝局灶性病变患者186例(206个病灶)。所有的受试者均接受超声造影和超声弹性成像检查,参照欧洲肝脏超声造影指南(2012版)标准进行肝局灶性病变良恶性的鉴别诊断。应用ROC曲线下面积判断指标诊断的效能。结果 在186例肝脏占位性病变患者中,肝左右叶病灶126例,肝左叶病灶29例,肝右叶病灶31例;超声共发现病灶206个,其中良性病灶78个(37.9%),恶性病灶128个(62.1%)。在78个良性病灶中,血管瘤51个,肝脓肿10个,错构瘤4个,结节性增生5个,炎性假瘤8个。在128个恶性病灶中,原发性肝癌124个,转移癌4个;超声造影检查诊断的ROC曲线下面积为0.967,显著优于超声弹性成像检查的0.803(P<0.05),超声造影检查诊断的敏感性、特异性和准确性分别为95.6%、98.6%和96.8%,显著优于超声弹性成像检查的89.1%、76.8%和84.4%(P<0.05)。结论 CUES检查对判断肝占位性病变的性质具有较高的诊断效能,与超声弹性成像检查具有协同作用,临床医师可以通过这些检查确定肝内病灶的性质。  相似文献   

6.
目的探讨超声造影对肝脏局灶性病变的诊断价值。方法收集2013年7月至2015年6月于广西南宁市第二人民医院经病理确诊为肝脏局灶性病变的68例患者,所有患者均接受常规超声及超声造影检查,分析超声造影对肝脏局灶性病变的诊断价值。结果 (1)动脉期24例HCC患者超声造影可见瘤内血管,以瘤内血管作为HCC超声造影诊断标准,其准确率为77.42%;门静脉期26例HCC可见均质或不均质增强,以其作为诊断HCC标准,准确率为83.87%;延迟期以血管充填作为良性病灶诊断标准,其诊断准确率高达81.82%。(2)恶性病变增强开始时间[(14.87±4.68)s]短于良性病变[(18.12±5.78)s],抵达增强峰值时间[(34.08±10.26)s]短于良性病变[(81.62±32.31)s],其增强减退时间[(71.64±17.48)s]同样短于良性病变[(313.54±105.21)s],差异均有统计学意义(P0.05)。(3)超声造影后,良性病灶显示率自27.27%提高至63.64%,造影前后良性病灶血流显示率对比差异有统计学意义(P0.05),46例恶性病灶血流显示率自60.87%上升至86.96%,对比差异有统计学意义(P0.05)。结论超声造影对良恶性病变血流显示率高,且恶性病变者增强开始时间、抵达峰值时间与消退时间均快于良性病变,可将其作为良恶性肝脏病变鉴别诊断的依据。  相似文献   

7.
汤颖  刘彦君  温瑜鹏  崔海峡  任群 《肝脏》2016,(10):827-830
目的探讨超声造影对肝脏局灶性病变的临床诊断价值。方法回顾性分析110例肝脏局灶性病变患者的超声造影检查结果,分析造影表现特征,并经手术或穿刺病理结果证实。结果以手术或穿刺病理确诊结果为标准,超声造影检查对良、恶性肝脏局灶性病变的诊断率分别为97.5%、96%,差异无统计学意义(P0.05)。良性病变的增强时间、达峰时间及消退时间均明显晚于恶性病变,差异均具有统计学意义(P0.05)。本组110例肝脏局灶性病变患者超声造影检查诊断出病变114个,表现特征分别为:肝内胆管细胞癌47个,为快进快出特征;肝细胞癌5个,为快进慢出特征;肝转移癌22个,为快进快出特征;肝血管癌20个,为快进快出特征;肝硬化结节7个,为快进快出特征;局灶性脂肪肝8个,为等进等出特征;局灶性结节增生2个,为快进慢出特征;肝脓肿3个,为快进快出特征。结论超声造影对良性和恶性肝脏局灶性病变的鉴别诊断准确率较高,并能清晰反映出不同性质病变的造影增强特征,具有较高的实用价值,值得进一步推广与应用。  相似文献   

8.
目的探讨超声造影时间-强度曲线(TIC)诊断老年肝脏局灶性病灶临床应用价值。方法选取80例老年肝脏局灶性病灶患者为研究对象,所有对象行超声造影、穿刺活检或手术病理诊断,将穿刺活检或手术病理诊断结果作为"金标准",分析超声造影诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值,并观察肝脏局灶性病灶超声造影增强模式、良恶性病灶TIC声学定量指标。结果经穿刺活检或手术病理诊断得知,80例老年肝脏局灶性病灶患者中26例确诊为恶性,12例原发性肝癌,14例肝转移癌;54例确诊为良性,32例肝血管瘤,16例肝硬化再生结节,6例局灶性结节性增生。依据穿刺活检或手术病理诊断"金标准",超声造影诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为92.31%、94.44%、93.75%、88.89%、96.23%;超声造影诊断与穿刺活检或手术病理诊断结果具有极好的一致性(Kappa=0.859)。原发性肝癌、肝转移癌超声造影多以不均匀增强模式为主,肝血管瘤以向心性增强模式为主,肝硬化再生结节、局灶性结节性增生均为等增强模式。良恶性病灶强度增量比较,差异无统计学意义(P0.05);良性病灶增强时间明显高于恶性病灶,上升支斜率、下降支斜率均明显低于恶性病灶,差异均有统计学意义(均P0.05)。结论超声造影诊断老年肝脏局灶性病灶具有良好应用价值,可有效区分病灶良恶性,而不同类型病灶超声造影增强模式不同,且良恶性病灶TIC声学定量指标存在差异。  相似文献   

9.
刘洋洋  杨星星  葛舒 《肝脏》2023,(11):1310-1313
目的 分析3.0T磁共振扩散加权成像(MRI-DWI)结合超声造影应用于肝脏良恶性病变中的诊断效果。方法 选择2020年2月至2022年7月就诊的肝脏占位性病变患者69例。所有患者均采用3.0TMRI-DWI、超声造影及病理检查,比较肝脏良性病变与肝脏恶性病变患者表观弥散系数(ADC)值和病灶的超声造影参数。分析3.0TMRI-DWI、超声造影及二者联合检查对肝脏良恶性病变的诊断效能。结果 69例肝脏占位性病变患者中肝脏良性病变38例(55.07%,共有47个病灶),肝脏恶性病变31例(44.93%,共有38个病灶)。肝脏恶性病变患者ADC值比肝脏良性病变患者低(P<0.05)。肝脏恶性病灶峰值强度比肝脏良性病灶高(P<0.05),肝脏恶性病灶始消时间、始增时间及达峰时间均比肝脏良性病灶短(P<0.05)。3.0TMRI-DWI检查、超声造影检查及二者联合检查诊断肝脏良恶性病变的准确率分别为82.61%、68.12%、94.20%,灵敏度分别为88.87%、70.97%、93.55%、特异度分别为81.57%、65.79%、94.74%,与病理诊断的Kappa值分别为...  相似文献   

10.
目的对直径≤3 cm的局灶性肝脏病变进行超声造影检查,并探讨该方法对肝脏疾病诊断的指导意义。方法回顾性分析我院2014年8月至2016年8月收治的68例肝脏局灶性病变患者的临床资料,根据患者的病灶直径大小进行分组,并进行超声造影检查,记录分析结果,并与最终的诊断对比分析。结果超声造影检验对肝内局灶性病变的准确率为95.6%,敏感性为95.7%,特异性为95.6%,阳性预测值为91.7%,阴性预测值为97.7%;对不同直径的病灶病理检查发现,不同直径(0~1、1~2和2~3 cm)的病灶良恶性的比例无显著差别(P0.05);不同时相的造影结果显示,门静脉期中,1~2 cm的超声造影增强强度低的比例显著少于2~3cm病灶组,差异有统计学意义(P0.05),动脉相与延迟相的比较,两组病灶的增强强度无显著差异(P0.05)。结论超声造影对于≤3 cm的肝内局灶性病灶诊断价值较高,而门静脉期时,直径≤2 cm的肝内恶性病灶的影像学表现不典型,进行诊断时需结合其他临床表现及辅助检查。  相似文献   

11.
AIM To describe contrast-enhanced ultrasound(CEUS) features and evaluate differential diagnosis value of CEUS and conventional ultrasound for patients with benign and malignant gallbladder lesions. METHODS This study included 105 gallbladder lesions. Before surgical resection and pathological examination, conventional ultrasound and CEUS were performed to examine for lesions. Then, all the lesions were diagnosed as(1) benign,(2) probably benign,(3) probably malignant or(4) malignant using both conventional ultrasound and CEUS. The CEUS features of these gallbladder lesions were analyzed and diagnostic efficiency between conventional ultrasound and CEUS was compared.RESULTS There were total 17 cases of gallbladder cancer and 88 cases of benign lesion. Some gallbladder lesions had typical characteristics on CEUS(e.g., gallbladder adenomyomatosis had typical characteristics of small nonenhanced areas on CEUS). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were 94.1%, 95.5%, 80.0%, 98.8%and 95.2%, respectively. These were significantly higher than conventional ultrasound(82.4%, 89.8%, 60.9%, 96.3% and 88.6%, respectively). CEUS had an accuracy of 100% for gallbladder sludge and CEUS helped in differential diagnosis among gallbladder polyps, gallbladder adenoma and gallbladder cancer.CONCLUSION CEUS may provide more useful information and improve the diagnosis efficiency for the diagnosis of gallbladder lesions than conventional ultrasound.  相似文献   

12.
BACKGROUNDIt is important to differentiate benign and malignant focal liver lesions (FLLs) accurately. Despite the wide use and acceptance of shear wave elastography (SWE), its value for assessing the elasticity of FLLs and differentiating benign and malignant FLLs is still investigational. Previous studies of SWE for FLLs used mean elasticity as the parameter to reflect the stiffness of FLLs. Considering the inhomogeneity of tumor stiffness, maximal elasticity (Emax) might be the suitable parameter to reflect the stiffness of FLLs and to differentiate malignant FLLs from benign ones.AIMTo explore the value of SWE with Emax in differential diagnosis of solid FLLs.METHODSWe included 104 solid FLLs in 95 patients and 50 healthy volunteers. All the subjects were examined using conventional ultrasound (US) and virtual touch tissue quantification(VTQ) imaging. A diagnosis of benign or malignant FLL was made using conventional US. Ten VTQ values were acquired after 10 consecutive measurements for each FLL and each normal liver, and the largest value was recorded as Emax.RESULTSThere were 56 cases of malignant FLLs and 48 cases of benign FLLs in this study. Emax of malignant FLLs (3.29 ± 0.88 m/s) was significantly higher than that of benign FLLs (1.30 ± 0.46 m/s, P < 0.01) and that of livers in healthy volunteers (1.15 ± 0.17 m/s, P < 0.01). The cut-off point of Emax was 1.945, and the area under the curve was 0.978. The sensitivity and specificity of Emax were 92.9% and 91.7%, respectively, higher (but not significantly) than those of conventional US (80.4% for sensitivity and 81.3% for specificity). Combined diagnosis of conventional US and Emax using parallel testing improved the sensitivity to 100% with specificity of 75%.CONCLUSIONSWE is a convenient and easy method to obtain accurate stiffness information of solid FLLs. Emax is useful for differential diagnosis of FLLs, especially in combination with conventional US.  相似文献   

13.
目的探讨分析弥散加权成像(diffusion-weighted imaging,DWI)和表观扩散系数(apparent diffusion coefficient,ADC)在肝脏局灶性病变鉴别诊断中的应用价值。 方法对2016年8月至2017年5月庆云县人民医院65例有肝脏内局灶性病变(focal liver lesion,FLL)的患者的DWI扫描(b=50,400,800s/ mm2)进行回顾性分析。测量其中104个病灶(包括56个良性病变和48个恶性病变)实质部分的平均ADC值,避开内部坏死区。分别计算良性病变和恶性病变的特异度和敏感度。运用方差分析检测各类局灶性病变的组间差异。 结果恶性病变的平均ADC值为0.980×10-3mm2/s,明显低于良性病变的平均ADC值(1.433×10-3mm2/s),有统计学意义(P<0.05)。当ADC值为1.066×10-3mm2/s时,恶性肿瘤的特性度和敏感度分别为86.6%和73.6%。在所有的病灶中,约39.5%的病灶平均ADC值低于1.0×10-3mm2/s,这些病灶中恶性病变占90%。约20%的病灶平均ADC值大于1.5×10-3mm2/s,他们中有9.5%的为恶性病变。 结论DWI的应用提高了磁共振对于肝脏良恶性病变鉴别的能力,尽管ADC值不能作为肝局灶性病变良恶性鉴别的特异性指标,但其可以作为一项鉴别良恶性性病变的重要参考数据。  相似文献   

14.
AIM: The aim was to evaluate the diagnostic value of contrast-enhanced ultrasound in the differential diagnosis of focal liver lesions, in a blinded experiment. In clinical routine the examiner can generally be influenced by the patient's history. METHOD: 62 patients with focal liver lesions, which could not be clearly differentiated and diagnosed by conventional ultrasound, were examined with contrast-enhanced (BR1, SonoVue, Bracco) ultrasound and included in a blinded prospective and randomized study. The examinations performed on a Sequoia 512 (Acuson) in a coherent contrast imaging method were recorded by an S-VHS recorder and afterwards analyzed by an examiner who did not know the patient's history. The basis of the diagnosis was the dynamic appearance and enhancement of the ultrasound contrast enhancer in different phases of liver perfusion. The conformation of the diagnoses was made by corresponding reference methods, as computer tomography, magnetic resonance imaging, biopsy and clinical follow-up. RESULTS: The following diagnoses were confirmed by reference methods: 18 patients with metastases, 4 hepatocellular carcinomas, 19 haemangiomas, 6 focal nodular hyperplasias, 13 patients with focal fatty infiltration and 2 patients with focal fatty sparing. 59 out of 62 patients with one or more liver lesions were correctly diagnosed by contrast-enhanced ultrasound. CONCLUSION: Second-generation ultrasound contrast enhancers improve the differential diagnosis of benign and malignant liver lesions considerably, especially in a blinded study.  相似文献   

15.
目的:探讨超声内镜弹性成像(endoscopic ultrasound,EUS)在胰腺占位病变良恶性鉴别中的应用价值.方法:影像学结果并经超声内镜检查确定有胰腺占位性病变的患者入选,对目标病变行超声内镜弹性成像检查,按照弹性成像5分法对组织弹性成像进行评分,将弹性成像评分为12分归为良性,3-5分归为恶性病变.结果:自2009-06/2011-06,共27例符合标准的胰腺占位病变患者入选,其中胰腺癌19例,超声内镜弹性成像评分3分(n=11)、4分(n=5)、5分(n=3),无功能性良性内分泌肿瘤(4分)及低度恶性神经内分泌肿瘤(5分)各1例,炎性病变6例,评分1分(n=1)、2分(n=3)、3分(n=2).超声内镜弹性成像对27例胰腺占位病变良恶性鉴别中24例诊断准确,诊断灵敏度100%,特异度57.14%,阳性预测值86.96%,阴性预测值100%.结论:超声内镜弹性成像对胰腺良恶性病变的鉴别具有较高的准确性,可望为疾病诊断提供新的影像学手段,但其仍为一种影像学手段,具有一定的局限性,并不替代胰腺的细胞病理学检查.  相似文献   

16.
AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE.  相似文献   

17.
目的探讨超声造影对肝脏原发性恶性肿瘤动静脉瘘检出的应用价值。方法收集14例确诊肝脏原发性恶性肿瘤病灶的超声造影资料及经肝动脉数字减影血管造影的影像资料,对比观察动静脉瘘的影像表现。结果超声造影剂快速增强,消退的病灶存在明显动静脉瘘。结论超声造影可提示肿瘤病灶动静脉瘘存在,对选择临床治疗提供参考价值。  相似文献   

18.
目的 对比分析增强CT扫描与超声造影对肝脏占位性病变的临床诊断价值。方法 选择2012年3月~2015年5月在我院进行诊治的肝脏占位性病变患者81例,均进行增强CT扫描和超声造影。观察肝脏占位性病变增强CT和超声造影表现特征,记录并比较肝脏良恶性病变患者的超声造影参数,比较增强CT扫描与超声造影对肝脏占位性病变的诊断效能。结果 本组包括肝细胞癌41例,肝硬化再生结节7例,肝脓肿5例,肝腺瘤3例,肝血管瘤18例,肝局灶性结节性增生7例;经过量化分析,41例肝脏恶性病变患者达峰时间[(33.2±5.8) s]、上升时间[(24.1±4.9) s]和平均通过时间[(108.5±21.3) s]均明显低于40例肝脏良性病变患者[分别为(48.6±13.2) s、(38.7±11.5) s 和(156.7±35.6) s,P<0.05],灌注指数(145.3±39.2)明显高于肝脏良性病变患者[(83.6±17.9),P<0.05];超声造影诊断的敏感度为97.1%,特异度为92.3%,诊断正确率为96.3%,而增强CT扫描则分别为80.3%(P<0.05)、91.2%(P>0.05)和85.2%(P<0.05)。结论 超声造影在诊断肝脏良恶性占位性病变方面能在形态学和数据测量方面提供丰富的反映肝脏占位性病变的影像学信息,且具有较高的诊断灵敏度和诊断正确率。  相似文献   

19.
AIM: To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones. METHODS: Forty-six nodules in 36 patients (29 men and 7 women) were studied by contrast-enhanced C3-MODE technology and contrast-enhanced CT in 1 wk before the biopsy or operation. A low MI monitor and a high MI flash imaging were intermittently performed. After the injection of contrast agent, the period from 10 to 30 s and the time later than 100 s were respectively defined as early arterial phase and the late phase. The vascularities of the liver nodules in the two phases were combined for differential diagnosis. Corresponding to the pathological diagnosis, the accuracy, sensitivity and specificity of contrast-enhanced C3-MODE technology were compared to those of contrast-enhanced CT. RESULTS: By C3-MODE technology, 33 of the 46 liver nodules were demonstrated as defected area in the late phase and were diagnosed as malignant tumors. Of them, 28 with hypervascularity in the early arterial phase were assessed as hepatocellular carcinoma, the other five nodules with rim-like enhancement in the early arterial phase were diagnosed as metastatic tumors. Thirteen nodules were shown as iso or hypervascularity in the late phase as well as centripetal filling in the early arterial phase and we made a diagnosis of hemangioma. Corresponding to the pathological results, the sensitivity, specificity and accuracy of contrast-enhanced C3-MODE technology in differentiating malignant and benign nodules in the liver were 97.0%, 92.3% and 95.7%, respectively. With comparison to those of contrast CT (sensitivity, 94.1%; specificity, 91.7%; accuracy, 93.5%), the difference was not significant. CONCLUSION: Contrast-enhanced C3-MODE technology can effectively differentiate malignant liver tumors from the benign nodules. It highly agrees diagnostically with the pathology. We suggest that it provides a new approach for differential diagnosis of liver nodules in addition to contrast-enhanced CT.  相似文献   

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