超声造影对肝脏肿瘤良恶性鉴别诊断的临床价值

目的评价超声造影对比常规超声及增强CT在提高肝脏良恶性肿瘤鉴别诊断中的临床价值。方法对71例常规超声检出的肝脏局灶性病变,根据二维及彩色多普勒特点,结合病史给出初步良恶性判断后,进一步超声造影检查,对病灶造影剂灌注过程进行分析,得出综合判断;所有患者均行增强CT检查,最后以病理结果为金标准,进行统计学分析。结果根据常规超声检查特点,初步诊断：良性肿瘤21例（29.6%）,恶性肿瘤50例（70.4%）;经超声造影诊断：良性肿瘤24例,恶性肿瘤47例;增强CT诊断：良性肿瘤26例,恶性肿瘤45例;经病理检查,良性肿瘤25例,恶性肿瘤46例。超声造影检查肝脏良恶性肿瘤诊断敏感性为93.61%,特异性为91.67%,准确度为92.96%,明显优于常规超声。超声造影与增强CT在诊断肝脏良恶性肿瘤方面差异无统计学意义（P〉0.05）。结论超声造影与增强CT在诊断肝脏的肿瘤及良恶性鉴别诊断中均有较高的临床价值。

Clinical value of diagnosis in benign and malignant hepatic tumors by contrast-enhanced ultrasonography

Objective To evaluate the clinical value of improving differential diagnosis in benign and malignant hepatic tumors by contrast-enhanced ultrasonography（CEUS） with conventional ultrasonography and contrastenhanced CT（CECT）. Methods 71 cases were found with focal liver lesion by conventional ultrasonography and color Doppler characteristics through retrospective analysis.CEUS was further applied after initial diagnosis of benign or malignant tumor was given combining with the history.The contrast media perfusion process in the lesion was analyzed and corrected judgement was given.All patients underwent CECT,and finally statistical analysis was done with pathological results as the gold standard. Results According to the results of conventional ultrasonography characteristics,preliminary diagnosis：benign tumor in 21 cases（29.6%）,50 cases of malignant tumors（70.4%）;by CEUS in diagnosis： benign tumor in 24 cases,47 cases of malignant tumor;CECT diagnosis：benign tumor in 26 cases,45 cases of malignant tumor.The pathological result showed there were 25 cases with benign lesions and 46 cases with malignant lesions in 71 lesions.CEUS in the differential diagnosis of benign or malignant lesions was obviously better than conventional ultrasonography with the sensibility of 93.61%,the specificity of 91.67% and the accuraty of 92.96%.There is no significant difference between CEUS and CECT in diagnosis of benign and malignant tumor（P〉0.05）. Conclusion There is a higher clinical value in differential diagnosis of benign and malignant local lesions by CEUS and CECT.