Sun Kun, Zhu Wei, Luo Yan, Li Yongzhong, Zhou Xiang
J Comput Assist Tomogr. 2018 Jan/Feb;42(1):133-138. doi: 10.1097/RCT.0000000000000659.
This study aimed to investigate the correlation between the transient segmental enhancement (TSE) of liver abscesses on contrast-enhanced ultrasound (CEUS) imaging and contrast-enhanced computed tomography (CT) scans.
In total, 42 abscesses in 38 patients were evaluated with real-time CEUS and contrast-enhanced CT imaging. The CT imaging and CEUS examinations were performed within one to 2 days of each other in all cases. The initial reports of the observations of TSE on CEUS scans were correlated later with the findings of TSE on contrast-enhanced CT images. Contrast-enhanced CT was used as the reference standard to evaluate the presence of TSE. Relationships between the 2 groups were analyzed using the χ test. P < 0.05 was considered to be statistically significant.
In 16 patients, 16 typical TSE signs were shown by CEUS. Meanwhile, enhanced CT imaging showed 18 typical signs of TSE in 17 patients. We identified 38 patients with hepatic abscesses proven by needle aspiration (10 patients) or image-guided biopsy (28 patients). Ten patients had hepatobiliary cholelithiasis, 5 had diabetes mellitus type 2, and 2 had gastric cancer, whereas no evidence of underlying hepatobiliary or gastrointestinal diseases was found in the other 21 patients. Considering that enhanced CT is the reference standard for the diagnosis of hepatic abscesses, the sensitivity of CEUS in showing TSE was 89%, and the specificity was 100%. The χ test indicated that CEUS and enhanced CT were significantly correlated for detection of hepatic perfusion disorders (P < 0.05).
The appearance of TSE in liver abscess was reliably detected by CEUS, which correlated well with the enhanced CT images (P < 0.05).
本研究旨在探讨肝脓肿在超声造影（CEUS）成像上的瞬时节段性强化（TSE）与对比增强计算机断层扫描（CT）之间的相关性。
对38例患者的42个脓肿进行实时CEUS和对比增强CT成像评估。所有病例中，CT成像和CEUS检查在彼此1至2天内进行。CEUS扫描上TSE的初始观察报告随后与对比增强CT图像上的TSE结果相关联。以对比增强CT作为评估TSE存在的参考标准。使用χ检验分析两组之间的关系。P<0.05被认为具有统计学意义。
16例患者的CEUS显示出16个典型的TSE征象。同时，增强CT成像在17例患者中显示出18个典型的TSE征象。我们确定了38例经针吸活检（10例）或影像引导活检（28例）证实的肝脓肿患者。10例患者有肝胆结石，5例患有2型糖尿病，2例患有胃癌，而其他21例患者未发现潜在的肝胆或胃肠道疾病证据。考虑到增强CT是肝脓肿诊断的参考标准，CEUS显示TSE的敏感性为89%，特异性为100%。χ检验表明，CEUS和增强CT在检测肝脏灌注障碍方面显著相关（P<0.05）。
CEUS能够可靠地检测到肝脓肿中TSE的表现，且与增强CT图像相关性良好（P<0.05）。
