超声造影在局灶性结节增生评估中的应用——一项多中心研究结果。

Contrast-enhanced ultrasound for the assessment of focal nodular hyperplasia - results of a multicentre study.

机构信息

Department of Gastroenterology and Hepatology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Timișoara, Romania.

Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania.

出版信息

Med Ultrason. 2021 May 20;23(2):140-146. doi: 10.11152/mu-2912. Epub 2021 Apr 22.

DOI:10.11152/mu-2912

PMID:33945596

Abstract

AIM

Contrast-enhanced ultrasound (CEUS) has become a relevant imaging method for the evaluation of focal liver le-sions (FLL). The aim of this study was to evaluate the performance of CEUS for the assessment of focal nodular hyperplasia (FNH) in a large study group.

MATERIAL AND METHODS

We performed a multicentre prospective observational study, which included successive CEUS examinations from fourteen Romanian centres. CEUS examinations were performed in de novo FLL, using low mechanical index ultrasound, following an intravenous bolus of 2.4 ml SonoVue. CEUS was considered conclusive for FNH if a typical pattern was present following contrast (rapid "spoke-wheel" enhancement during the arterial phase, hyperenhanced lesion during venous phase, hyper- or isoenhanced in the late phase). In all cases a reference method was available (contrast enhanced CT or MRI or biopsy). The trial was registered in clinicaltrials.gov (Identifier NCT01329458).

RESULTS

During the 6 years study, 2062 "de novo" FLL were evaluated by CEUS. From this cohort, 94/2062 (4.5%) had a typical enhancing pattern for FNH as described in the EFSUMB guidelines. Contrast enhanced CT/MRI and biopsy diagnosed additional 15 FNH. From the 94 cases diagnosed as FNH by CEUS, in nine the final diagnosis was different (five of them adenomas). CEUS had 85% sensitivity, 99.5% specificity, 90.4% positive predictive value, 99.2% negative predictive value and 98.8% diagnostic accuracy for the diagnosis of FNH.

CONCLUSIONS

CEUS is a sensitive and very specific method for the diagnosis of FNH.

摘要

目的

超声造影（CEUS）已成为评估局灶性肝脏病变（FLL）的一种重要影像学方法。本研究旨在评估 CEUS 在大型研究组中评估局灶性结节增生（FNH）的性能。

材料和方法

我们进行了一项多中心前瞻性观察性研究，该研究包括来自 14 个罗马尼亚中心的连续 CEUS 检查。使用低机械指数超声在新出现的 FLL 中进行 CEUS 检查，在静脉内推注 2.4ml SonoVue 后进行。如果存在典型模式（动脉期快速“辐轮”增强，静脉期高增强病变，晚期高或等增强），则认为 CEUS 对 FNH 的诊断具有决定性。在所有情况下，均存在参考方法（对比增强 CT 或 MRI 或活检）。该试验已在 clinicaltrials.gov 上注册（标识符 NCT01329458）。

结果

在 6 年的研究期间，对 2062 例“新发”FLL 进行了 CEUS 评估。在该队列中，94/2062（4.5%）具有 EFSUMB 指南中描述的 FNH 的典型增强模式。增强 CT/MRI 和活检诊断出另外 15 例 FNH。在 94 例通过 CEUS 诊断为 FNH 的病例中，最终诊断在 9 例中不同（其中 5 例为腺瘤）。CEUS 对 FNH 的诊断具有 85%的敏感性、99.5%的特异性、90.4%的阳性预测值、99.2%的阴性预测值和 98.8%的诊断准确性。