超声造影与常规超声在诊断海绵状肝血管瘤中的应用比较

目的 探讨超声造影与常规超声诊断海绵状肝血管瘤的临床应用价值。 方法 选取2015年2月1日-2017年2月1日来杭州师范大学附属医院接受治疗的疑似海绵状肝血管瘤患者82例,进行常规超声以及超声造影筛检试验,观察2种方法的诊断灵敏度、特异度、误诊率、漏诊率、约登指数和影像诊断表现。 结果 病理诊断结果显示82例患者中有57例患者被确诊,57例患者共发现64个病灶;超声造影诊断肝血管瘤的灵敏度为87.72%,特异度为80.00%,约登指数为0.68,Kappa值为0.662;常规超声诊断灵敏度为59.65%,特异度为68.00%,约登指数为0.28,Kappa值为0.237;超声造影诊断肝血管瘤的灵敏度显著高于常规超声,差异具有统计学意义(χ2=11.581,P<0.001);常规超声有34例患者呈现高回声,考虑为血管瘤,有8例被误诊,23被漏诊;在超声造影发现的59个病灶中,超声造影共表现出2种增强方式:①周边向中心完全充填,35个病灶;②充填时间缩短,整体性增强,14个病灶。同时发现,低回声病灶4个,5例患者被误诊,7例被漏诊。 结论 超声造影应用于诊断肝血管瘤具有较高的灵敏度和特异度,漏诊率和误诊率较低,能够有效的区分高、低回声灶,值得在临床上推广。 

Clinical application of contrast-enhanced ultrasonography in the diagnosis of hepatic hemangioma

Objective To evaluate the clinical value of contrast-enhanced ultrasonography in the diagnosis of hepatic hemangioma. Methods A total of 82 patients with suspected hepatic hemangioma received from February, 2015 to February, 2017 were enrolled in this study. All patients were diagnosed by enhanced CT or MRI, followed by conventional ultrasound and ultrasonography. Test diagnosis, observation of diagnostic sensitivity, specificity, misdiagnosis rate, missed diagnosis rate and Youden index, observe the image diagnosis performance. Results Totally 64 lesions were identified by pathology in 57 patients. The sensitivity, specificity and specificity of contrast-enhanced ultrasound in the diagnosis of hepatic hemangiomas were 87.72%, 80.00%, 0.68 for Youden index and 0.662 for Kappa, respectively. The sensitivity of routine ultrasound was 59.65% Degree of 68.00%, Youden index of 0.28, Kappa value of 0.237; contrast-enhanced ultrasound in the diagnosis of hepatic hemangiomas sensitivity was significantly higher than conventional ultrasound, the difference was statistically significant (χ2=11.581, P<0.001); conventional ultrasound in 34 cases 8 cases were misdiagnosed and missed by 23 cases. Among the 59 lesions found by contrast-enhanced ultrasound, CEUS showed two enhancement modes:① the perimeter was completely filled to the center and 35 lesions; ② filling time is shortened, the overall enhancement, 14 lesions, at the same time found 4 low-echo lesions, 5 patients were misdiagnosed, 7 patients were missed. Conclusion Ultrasonography can be used to diagnose hepatic hemangioma with high sensitivity and specificity. The rate of missed diagnosis and misdiagnosis rate is low, which can effectively distinguish between high and low echo foci and deserve clinical promotion.