Department of Gynaecology and Obstetrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Ultrasound, Nanchong Central Hospital, Sichuan, China.
J Clin Lab Anal. 2020 Jun;34(6):e23231. doi: 10.1002/jcla.23231. Epub 2020 Feb 3.
In this study, the efficacy of US/CEUS and clinicopathologic parameters in differential diagnosis of hepatic inflammatory lesions were evaluated.
This was a retrospective study in which CEUS imaging was performed on 182 patients. Among these patients, 44 patients had hepatic inflammatory lesions and 138 patients had malignant lesions. The ultrasound (US), CEUS, and clinicopathologic parameters with respect to differential diagnosis of hepatic inflammatory lesions were analyzed.
Irregular lesion shape and unclear margin were commonly seen in hepatic inflammatory lesions by US/CEUS examination. Hypoenhancement in arterial phase (AP) and portal venous phase (PVP), and isoenhancement in delayed phase (DP) were more commonly found in inflammatory lesions rather than malignant lesions [9% (4/44), 68% (30/44), and 16% (7/44) vs 2% (3/138), 11% (15/138), 1% (1/138), respectively; P < .05]. The enhancement coverage was also a significant indicator for the differentiation of inflammatory lesions and malignant lesions (P < .05). History of hepatitis or cirrhosis, and higher serum alpha-fetoprotein (AFP) level were indicators for malignant lesions, while liver parasites and higher body temperature were indicators for inflammatory lesions. When the US/CEUS findings were combined with clinicopathologic parameters, the diagnostic accuracy of inflammatory lesions could reach 93.3%, with sensitivity, specificity, positive predictive value, and negative predictive value of 63.64%, 96.03%, 84.85%, and 88.32%, respectively.
The US/CEUS findings combined with clinical characteristics can accurately differentiate hepatic inflammatory lesions and malignant lesions. The results of study will improve the diagnostic confidence for hepatic inflammatory lesions.
本研究旨在评估超声/超声造影（US/CEUS）与临床病理参数在肝脏炎性病变鉴别诊断中的作用。
这是一项回顾性研究，对 182 例患者进行了 CEUS 成像检查。其中 44 例患者为肝脏炎性病变，138 例患者为恶性病变。分析了超声/CEUS 及与肝脏炎性病变鉴别诊断相关的临床病理参数。
US/CEUS 检查发现肝脏炎性病变多呈形态不规则、边界欠清。动脉期（AP）低增强、门脉期（PVP）高增强、延迟期（DP）等时相多呈等增强在炎性病变中较恶性病变更为常见[9%（4/44）、68%（30/44）和 16%（7/44）比 2%（3/138）、11%（15/138）和 1%（1/138）；P<.05]。增强范围也是鉴别炎性病变和恶性病变的一个重要指标（P<.05）。肝炎或肝硬化病史和血清甲胎蛋白（AFP）水平升高提示恶性病变，而肝寄生虫和体温升高提示炎性病变。当 US/CEUS 结果与临床病理参数相结合时，炎性病变的诊断准确性可达 93.3%，敏感性、特异性、阳性预测值和阴性预测值分别为 63.64%、96.03%、84.85%和 88.32%。
US/CEUS 表现结合临床特征可准确鉴别肝脏炎性病变和恶性病变。研究结果将提高对肝脏炎性病变的诊断信心。
