Department of Radiology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2010;46(5):329-35.
To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas.
The study enrolled 48 patients, aged between 20 and 79 years (35 [72.9%] women, 13 [27.1%] men; mean age, 53.5+/-12.855 years), who were examined and treated in the Departments of Gastroenterology, Surgery, and Oncology, Hospital of Kaunas University of Medicine, in the year 2007. All patients underwent intravenous contrast-enhanced US, intravenous contrast-enhanced CT, and MRI and were diagnosed with hepatic hemangioma according to the findings of these examinations.
The size of hemangiomas was < or =2.0 cm in 20 cases (41.7%) and >2.0 cm in 28 (58.3%). No association between hepatic hemangioma and patient's age was found (chi(2)=0.547, df=2, P=0.761). Nearly one-third of hemangiomas were located in the segment IV of the left hepatic lobe. There were a few complicated hemangiomas in the study sample: 2 with calcification and 1 with necrosis. The sensitivity of CT in the diagnosis of hepatic hemangioma was 76.92%; specificity, 33.3%; positive prognostic value, 83.3%; and negative prognostic value, 25.0%. The sensitivity of intravenous contrast-enhanced US in the diagnosis of hepatic hemangioma was 77.8%; specificity, 100%; positive prognostic value, 100%; and negative prognostic value, 23.1%.
Intravenous contrast-enhanced US is more specific than intravenous contrast-enhanced CT in the diagnosis of hepatic hemangioma (P=0.0005) and has a higher positive prognostic value (P=0.001).
比较静脉内对比增强超声(US)、静脉内对比增强计算机断层扫描(CT)和磁共振成像(MRI)在诊断肝血管瘤中的价值。
本研究纳入了 2007 年在考纳斯医科大学胃肠病学、外科学和肿瘤学系接受检查和治疗的 48 名年龄在 20 至 79 岁(35 名[72.9%]女性,13 名[27.1%]男性;平均年龄 53.5+/-12.855 岁)的患者。所有患者均接受了静脉内对比增强 US、静脉内对比增强 CT 和 MRI 检查,并根据这些检查结果诊断为肝血管瘤。
血管瘤的大小<或=2.0cm 者 20 例(41.7%),>2.0cm 者 28 例(58.3%)。未发现肝血管瘤与患者年龄之间存在相关性(卡方=0.547,自由度 df=2,P=0.761)。将近三分之一的血管瘤位于左肝叶的第四段。在研究样本中,有几个复杂的血管瘤:2 个有钙化,1 个有坏死。CT 诊断肝血管瘤的敏感性为 76.92%;特异性为 33.3%;阳性预测值为 83.3%;阴性预测值为 25.0%。静脉内对比增强 US 诊断肝血管瘤的敏感性为 77.8%;特异性为 100%;阳性预测值为 100%;阴性预测值为 23.1%。
静脉内对比增强 US 比静脉内对比增强 CT 更特异(P=0.0005),阳性预测值更高(P=0.001)。