超声造影鉴别诊断肝脏局灶性病变的价值

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。

Differential diagnosis value of ultrasonic contrast for focal liver lesions

Objective To investigate the differential diagnosis value of ultrasonic contrast for focal liver lesions. Methods One hundred and ten patients,which were pathologically diagnosed as focal liver lesions from May 2014 to December 2015 in our hospital,were enrolled,and their clinic data and ultrasonic contrast results were retrospectively analyzed.Results Based on the pathological diagnosis,the diagnostic accuracy of contrast-enhanced ultrasound in benign and malignant liver lesions were 97.5% and 96%,respectively (P >0.05).The enhanced time,peak time and regression time of contrast-enhanced ultrasound were longer in benign lesions than those in malignant lesions (P <0.05).There were 114 focal liver lesions detected in all those patients,containing 47 intrahepatic cholangiocarcinoma lesions with sonogram as fast-in and fast-out,5 hepatocellular carcinoma as fast-in and slow-out,22 hepatic metastasis as fast-in and fast-out,20 vascular liver cancer as fast-in and fast-out,7 cirrhotic nodules as fast-in and fast-out,8 focal fatty liver as same-in and same-out,2 focal nodular hyperplasia as fast-in and slow-out,and 3 liver abscess as fast-in and fast-out.Conclusion Ultrasonic contrast in differential diagnosis of benign and malignant focal liver lesion showed high accuracy,and couldclearly reflect the sonogram characteristics of various lesions,which was worthy of popularization and application.