低机械指数实时超声造影评价恶性肿瘤治疗后肝内复发转移的临床研究

目的:探讨低机械指数超声造影成像技术定性诊断恶性肿瘤治疗后肝内可疑复发转移病灶的价值。材料和方法:78个肝脏局灶性病变,同期行实时超声造影、CT增强检查,最终诊断经穿刺活检病理证实62个结节,另13个局部治疗后坏死结节及3个增生结节经综合影像及12~34个月随访证实。结果:超声造影诊断的敏感性96.2%,特异性92.3%,准确性94.9%,阳性预测值92.3%,阴性预测值96.2%。70个结节同期CT增强诊断,结果与最终诊断及超声造影诊断的一致性比较无统计学差别。结论:实时超声造影是定性诊断肝局灶性病变的有效方法,尤其对经肝动脉栓塞后碘油沉积病灶残存血流灌注的评判较CT具有优势。

The Value of Contrast-enhanced Ultrasound with Low MI in Assessing the Suspected Focal Recurrence or Metastasis after Treatment of Liver Malignant Tumors

Purpose: The low MI ultrasound with contrast-enhancement was evaluated in assessing the suspected focal recurrence or metastasis after treatment of liver malignancies.Materials and Methods: 61 patients with 78 suspected hepatic lesions underwent contrast-enhanced ultrasonic imaging and contrast-enhanced CT.The final diagnosis of 62 lesions was confirmed histologically via ultrasound-guided biopsy.The other 13 necrotic lesions and 3 nodules of cirrhotic hyperplasia were confirmed by combining images and 12~34 months follow up.Results: The sensitivity,specificity and accuracy of contrast-enhanced ultrasound diagnosis were 96.2%,92.3% and 94.9%,respectively.The positive predict value was 92.3%,the negative predict value was 96.2%.There is no significant difference between contrast-enhanced ultrasound,contrast-enhanced CT and final diagnosis in 70 lesions.Conclusion: Low MI contrast-enhanced ultrasound was useful in confirming the recurrence or metastasis after treatment of malignant liver tumour,especially of advantage comparing with CT in assessing the blood flow perfusion in residual tumors after transarterial chemoemblization.