超声造影诊断肝脾外伤的临床应用研究

目的探讨超声造影技术（CEUS）在肝脾外伤诊断中的临床应用价值。方法分析25例肝脾外伤患者常规超声、CEUS完整资料，分析肝脾损伤的CEUS表现，并与手术和CT增强比较分析常规超声、CEUS的敏感度、特异度及其分级的准确率。结果经手术或CT证实23例为肝脾损伤，其中单纯肝破裂8例、单纯脾破裂13例，肝脾复合伤2例。与手术或CT诊断对照，CEUS的敏感度和特异度分别为90．5％和66．7％，显著高于常规超声的59．1％和33．3％（P〈0．05）；CEUS的分级符合率为91．3％（21／23），显著高于常规超声的65．2％（15／23），两者差异有统计学意义（P〈0．05）。结论CEUS诊断肝脾损伤的敏感度、特异度较高，且其分级诊断正确率较高，能够较准确评价肝脾损伤的程度，其在肝脾损伤的诊断及指导临床选择治疗方案中具有重要的临床应用价值。

Clinical application of contrast-enhanced ultrasound in diagnosis of liver and spleen trauma

Objective To discuss clinical application value of contrast-enhanced ultrasound(CEUS) technology in the diagnosis of liver and spleen trauma. Methods Retrospective analysis 25 cases of liver and spleen trauma patients, the conventional ultrasonic CEUS complete material, analysis of the liver and spleen damage CEUS performance,and with surgery and computed tomography(CT) strengthen comparative analysis of the sensitivity of the conventional ultrasonic, CEUS, specific degree and the classification accuracy. Results Among the surgery or CT confirmed 23 cases for liver and spleen rupture,the pure 8 cases liver, injury 13 cases of pure spleen rupture ,liver and spleen composite injury in 2 cases. And surgery or CT comparison, the sensitivity of the CEUS and specific degrees were 90.5％ and 66.7％ ,significantly higher than conventional ultrasound 59. 1％ and 33.3％ (P ＜0.05) ;CEUS classification was 91.3％ (21/23), significantly higher than the rules of ultrasound was 65.2％ ( 15/23 ), both differences were statistically significant( P ＜ 0.05). Conclusion CEUS diagnosis liver and spleen, due to the sensitivity of the damage degree high, and the classification accuracy was higher, the diagnosis to accurately evaluate the extent of the damage to the liver and spleen in liver and spleen, the loss of the diagnosis and treatment of clinical guidelines choice had important value of clinical application.