Dipartimento di Biotecnologie Mediche e Medicina Legale, Sezione di Diagnostica per Immagini, Policlinico Universitario, Via del Vespro 127, 90127 Palermo, Italy.
Radiol Med. 2010 Aug;115(5):714-31. doi: 10.1007/s11547-010-0506-3. Epub 2010 Jan 15.
The aim of this study was to assess the role of contrast-enhanced ultrasonography (CEUS) in the characterisation of focal liver lesions in comparison with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) with liver-specific contrast agent.
One hundred and eighty-seven focal liver lesions, 91 malignant and 96 benign (mean size 3.2 cm) - proved by biopsy (n=12), histology (n=4), MDCT (n=108), MRI (n=44) MDCT/MRI (n=19) - in 159 patients were studied by CEUS. Two expert radiologists consensually evaluated the contrast-enhancement patterns at CEUS. For each lesion, they assessed: (a) nature (benign, malignant, not assessable), (b) specific diagnosis and (c) need for further radiological evaluation. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of CEUS were calculated.
A total of 167/187 (89.3%) lesions were correctly assessed as benign or malignant at CEUS, whereas 14/187 (7.5%) lesions remained undetermined and 6/187 (3.2%) were incorrectly assessed. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of CEUS were, respectively, 89%, 89.6%, 89%, 89.6% and 89.3%. The need for further radiological evaluation decreased to 46/187 (24.6%) lesions after CEUS (p<0.001).
In selected cases, CEUS can be considered an effective alternative to MDCT and MRI and reduce the need for further radiological workup.
本研究旨在评估与多排螺旋 CT（MDCT）和磁共振成像（MRI）联合肝特异性对比剂相比，超声造影（CEUS）在局灶性肝脏病变特征描述中的作用。
对 159 例患者的 187 个局灶性肝脏病变（91 个恶性和 96 个良性病变，平均大小 3.2cm）进行了 CEUS 研究，这些病变通过活检（n=12）、组织学（n=4）、MDCT（n=108）、MRI（n=44）、MDCT/MRI（n=19）证实。两位专家放射科医生对 CEUS 增强模式进行了一致性评估。对于每个病变，他们评估了：（a）性质（良性、恶性、无法评估），（b）具体诊断，（c）是否需要进一步影像学评估。计算了 CEUS 的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。
CEUS 正确评估了 167/187（89.3%）个病变为良性或恶性，而 14/187（7.5%）个病变仍未确定，6/187（3.2%）个病变被错误评估。CEUS 的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 89%、89.6%、89%、89.6%和 89.3%。CEUS 后，进一步影像学检查的需求降至 46/187（24.6%）个病变（p<0.001）。
在选择病例中，CEUS 可以被认为是 MDCT 和 MRI 的有效替代方法，并减少进一步影像学检查的需要。
