Zentrum für Innere Medizin, Klinik für Innere Medizin I, Universitätsklinikum Ulm.
Ultraschall Med. 2010 Feb;31(1):31-6. doi: 10.1055/s-2008-1109309. Epub 2009 Mar 5.
The objective of the present study is to compare the utility of extended field-of-view ultrasonography and conventional B-mode ultrasonography for determining liver size.
The liver size in the medioclavicular line (MCL) was determined in 104 inpatients (females: n = 47; males: n = 57) using both ultrasound methods (Philips HDI 5000). The liver size measured in computed tomography (CT; MX 8000 IDT, Philips) served as the gold standard. The body mass index (BMI), ultrasound scanning conditions, and hepatomegaly identified by CT were evaluated as possible factors affecting the measurement accuracy of the sonographic methods.
The standard deviation of the differences between the measured pairs of values shows less dispersion in B-mode ultrasonography (18.7 mm) than panorama ultrasonography (20.8 mm). The mean value of differences between the measured pairs (bias) in the ultrasonographic methods compared to CT is considerably higher in panorama sonography (15.3 mm; SD = 20.8) than in B-mode ultrasonography (0.27 mm; SD = 18.7). A paired t-test of the mean values shows a significant difference between the ultrasonographic methods (p < 0.0001). In diagnosing or excluding hepatomegaly, B-mode sonography is consistent with CT findings in 84 (80.8 %) of 104 patients and panorama ultrasonography is consistent with CT findings in 77 (74.0 %) of 104 patients. Ultrasonographic methods show moderate agreement with each other (Kappa = 0.4265). Higher BMI and limited scanning conditions lead to an increase in the mean difference of measured pairs of values (bias) as well as to an increase in standard deviation of the differences (dispersion).
The determination of liver size in the medioclavicular line using panorama ultrasonography often leads to the false-positive diagnosis of hepatomegaly. Therefore, the method should not be recommended for routine diagnostic scans. In cases of significant hepatomegaly, however, panorama ultrasonography offers superior visualization compared to conventional B-mode ultrasonography.
本研究旨在比较扩展视野超声与传统 B 型超声在确定肝大小方面的应用。
采用两种超声方法（飞利浦 HDI 5000）测量 104 例住院患者（女性：n=47；男性：n=57）的锁骨中线（MCL）肝大小。CT（飞利浦 MX 8000 IDT）测量的肝大小作为金标准。评估体重指数（BMI）、超声扫描条件和 CT 确定的肝肿大作为影响超声方法测量准确性的可能因素。
测量值对差值的标准偏差显示 B 型超声（18.7mm）的离散度小于全景超声（20.8mm）。与 CT 相比，超声方法测量值之间的平均差值（偏差）在全景超声中明显更高（15.3mm；SD=20.8），而在 B 型超声中则较低（0.27mm；SD=18.7）。对平均值进行配对 t 检验显示，两种超声方法之间存在显著差异（p<0.0001）。在诊断或排除肝肿大方面，B 型超声与 CT 结果一致的患者有 84 例（80.8%），全景超声与 CT 结果一致的患者有 77 例（74.0%）。超声方法之间具有中度一致性（Kappa=0.4265）。较高的 BMI 和有限的扫描条件导致测量值对差值的平均值（偏差）增加，并且差值的标准差（离散度）增加。
使用全景超声测量锁骨中线肝大小常导致肝肿大的假阳性诊断。因此，该方法不应推荐用于常规诊断性扫描。然而，在明显肝肿大的情况下，全景超声提供了比传统 B 型超声更好的可视化效果。
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