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比较

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。

Comparative study of contrast-enhanced CT and contrast-enhanced ultrasonography in the diagnosis of patients with focal liver lesions

Objective To compare the value of contrast-enhanced CT and contrast-enhanced ultrasonography in the diagnosis of patients with focal liver lesions. Methods 81 patients with focal liver lesions were recruited in our hospital between March 2012 and May 2015. All the patients underwent contrast-enhanced CT check-up and contrast-enhanced ultrasonography. The imaging characteristics and the imaging parameters of ultrasonic contrast of benign and malignant liver lesions were recorded. Then，a comparison of the diagnostic efficacy of the two Methods was conducted. Results This study included 41 patients with hepatocellular carcinoma（HCC） and 40 with benign liver lesions. The quantitative analysis of the Results of contrast-enhanced ultrasonography revealed that time to peak，rise time and mean transit time in patients with malignant liver lesions were significantly shorter than those in patients with benign lesions （33.2±5.8） s vs. （48.6±13.2） s，（24.1±4.9） s vs. （38.7±11.5） s，（108.5±21.3） s vs. （156.7±35.6） s，respectively，P<0.05 for all]，while the perfusion index in patients with malignant liver lesions was significantly higher than that in patients with benign lesions（145.3±39.2） vs.（83.6±17.9），P<0.05]；The sensitivity，specificity，and accuracy of the contrast-enhanced ultrasonography were 97.1%， 92.3% and 96.3%，while those of contrast-enhanced CT were 80.3%（P<0.05），91.2%（P>0.05）and 85.2%（P<0.05）. Conclusion Contrast-enhanced ultrasonography could provide abundant imaging information of hepatic lesions in terms of morphology and data measurement，with high sensitivity and diagnostic accuracy in diagnosis of patients with liver lesions.