Hatanaka Kinuyo, Kudo Masatoshi, Minami Yasunori, Maekawa Kiyoshi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Japan.
Oncology. 2008;75 Suppl 1:42-7. doi: 10.1159/000173423. Epub 2008 Dec 17.
The purpose of this study was to assess the usefulness of Sonazoid-enhanced ultrasonography (US) in the diagnosis of hepatic malignancies in comparison with contrast-enhanced CT findings.
A total of 74 patients with 113 hepatic tumors having or highly suspected of having malignancies were enrolled. These hepatic nodules were diagnosed by typical findings of imaging such as contrast-enhanced CT, dynamic MRI or Sonazoid-enhanced US, tumor markers and histological examinations after surgical resection or biopsy.
108 nodules were diagnosed as malignant tumors (hepatocellular carcinoma: n = 90; metastasis: n = 16; intrahepatic cholangiocarcinoma: n = 2) and the remaining five tumors were diagnosed as benign tumors (dysplastic nodules: n = 5). Sonazoid-enhanced US correctly depicted the presence or absence of tumors in 74 patients, with a sensitivity of 95.4%, an accuracy of 94.7%, and a positive predictive rate of 99%. Contrast-enhanced CT depicted the malignancies with a sensitivity of 85.2%, an accuracy of 82.3%, and a positive predictive rate of 95.8%. There were significant differences between Sonazoid-enhanced US and contrast-enhanced CT for sensitivity and accuracy (both p < 0.05).
Sonazoid-enhanced US has a higher sensitivity and accuracy for the diagnosis of hepatic malignancies than contrast-enhanced CT.
本研究旨在比较索纳造影剂增强超声检查（US）与对比增强CT检查结果在肝恶性肿瘤诊断中的应用价值。
共纳入74例患者，其肝脏有113个肿瘤，已确诊或高度怀疑为恶性肿瘤。这些肝结节通过对比增强CT、动态MRI或索纳造影剂增强US等典型影像学表现、肿瘤标志物以及手术切除或活检后的组织学检查进行诊断。
108个结节被诊断为恶性肿瘤（肝细胞癌：90例；转移瘤：16例；肝内胆管癌：2例），其余5个肿瘤被诊断为良性肿瘤（发育异常结节：5例）。索纳造影剂增强US正确显示了74例患者肿瘤的有无，敏感性为95.4%，准确性为94.7%，阳性预测率为99%。对比增强CT诊断恶性肿瘤的敏感性为85.2%，准确性为82.3%，阳性预测率为95.8%。索纳造影剂增强US与对比增强CT在敏感性和准确性方面存在显著差异（均p<0.05）。
索纳造影剂增强US在肝恶性肿瘤诊断中的敏感性和准确性高于对比增强CT。
