Bartolotta Tommaso Vincenzo, Sandonato Luigi, Taibbi Adele, Latteri Stefania, Soresi Maurizio, Lombardo Giuseppina, Genova Claudio, Latteri Mario Adelfio
Unità Interdipartimentale per lo Screening, la Diagnosi ed il Trattamento delle Neoplasie Epatiche, Università degli Studi di Palermo, Dipartimento di Biotecnologie Mediche e Medicina Legale, Divisione di Scienze Radiologiche.
Chir Ital. 2009 May-Jun;61(3):295-307.
The aim of the study was to evaluate the role of contrast-enhanced ultrasound (CEUS) in the characterisation of focal liver lesions and for the selection of surgical patients. One hundred and thirty-five consecutive patients (71 women, 64 men) with 165 focal liver lesions (mean size: 3.1 cm)--89 benign (10 simple cysts, 26 haemangiomas, 29 focal nodular hyperplasia, 2 hepatocellular adenomas, 11 focal fatty sparing, 3 focal fatty areas, 5 regenerative nodules, 2 hydatid cysts, 1 abscess) and 76 malignant (47 metastases, 26 hepatocellular carcinomas and 3 peripheral cholangiocarcinomas)--underwent CEUS after the administration of SonoVue. Two radiologists reviewed baseline US and CEUS scans obtained 25-30 sec (arterial phase), 55-80 sec (portal-venous phase), and 235-260 sec (late phase) after initiating SonoVue injection, respectively. The radiologists classified each lesion as malignant or benign on the basis of clearly defined diagnostic criteria. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. CEUS correctly characterised 156/165 focal liver lesions (94.5%), 85 benign and 71 malignant. Five focal liver lesions (3%; 3 haemangiomas and 2 hepatocellular carcinomas) remained undetermined after CEUS and 4 focal liver lesions (2.4%; 3 hepatocellular carcinomas and 1 abscess) were misdiagnosed. CEUS presented sensitivity, specificity, and diagnostic accuracy values of 93.4%, 95.5% and 94.7% respectively. Positive and negative predictive values were 94.7% and 94.4%, respectively. CEUS is a useful tool in the characterisation of focal liver lesions and for selecting surgical patients.
本研究的目的是评估超声造影（CEUS）在肝脏局灶性病变特征描述及手术患者选择中的作用。135例连续患者（71例女性，64例男性），共165个肝脏局灶性病变（平均大小：3.1 cm）——89个良性病变（10个单纯囊肿、26个血管瘤、29个局灶性结节性增生、2个肝细胞腺瘤、11个局灶性脂肪 sparing、3个局灶性脂肪区域、5个再生结节、2个包虫囊肿、1个脓肿）和76个恶性病变（47个转移瘤、26个肝细胞癌和3个周围胆管癌）——在注射声诺维后接受了CEUS检查。两名放射科医生分别回顾了在开始注射声诺维后25 - 30秒（动脉期）、55 - 80秒（门脉期）和235 - 260秒（延迟期）获得的基线超声和CEUS扫描图像。放射科医生根据明确的诊断标准将每个病变分类为恶性或良性。计算了敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。CEUS正确地对165个肝脏局灶性病变中的156个（94.5%）进行了特征描述，其中85个为良性，71个为恶性。5个肝脏局灶性病变（3%；3个血管瘤和2个肝细胞癌）在CEUS检查后仍无法确定，4个肝脏局灶性病变（2.4%；3个肝细胞癌和1个脓肿）被误诊。CEUS的敏感性、特异性和诊断准确性值分别为93.4%、95.5%和94.7%。阳性和阴性预测值分别为94.7%和94.4%。CEUS是肝脏局灶性病变特征描述及手术患者选择的有用工具。
