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增强超声与常规超声在肝脏局灶性病变活检中的临床价值。

Clinical value of contrast-enhanced ultrasound versus conventional ultrasound in biopsy of focal liver lesions.

机构信息

Department of Oncology, Third Affiliated Hospital of the Naval Medical University, Shanghai, PR China.

Department of Imaging Medicine Ultrasound Diagnosis Teaching and Research, Naval Medical University, Shanghai, PR China.

出版信息

Acta Radiol. 2024 Jul;65(7):700-707. doi: 10.1177/02841851241257607. Epub 2024 Jun 10.

Abstract

BACKGROUND

Focal liver lesions (FLLs) are a common form of liver disease, and identifying accurate pathological types is required to guide treatment and evaluate prognosis.

PURPOSE

To compare and analyze the application effect of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (US) in the clinical diagnosis of focal liver lesions.

MATERIAL AND METHODS

A retrospective analysis was performed on 682 patients with space-occupying liver lesions admitted to our hospital between December 2015 and August 2021. Of these, 280 underwent CEUS-guided biopsies and 402 underwent conventional US biopsies, with the results of each biopsy subsequently compared between the two groups. The success rate and accuracy of the biopsies and their relationship with different pathological features were also analyzed.

RESULTS

The success rate, sensitivity, diagnostic accuracy, positive predictive value, and negative predictive value of the CEUS group were significantly higher than those of the US group ( < 0.05). Lesion size accuracy in the CEUS group was significantly higher than that in the US group (89.29% vs. 40.55%;  < 0.05). Lesion type accuracy in the CEUS group was significantly higher than that in the US group (86.49% vs. 43.59%), and the difference between the two groups was statistically significant ( < 0.05). The logistic regression analysis indicated that malignant lesions, lesions ≥5 cm, and lesions ≤1 cm were independent factors affecting the success rate of the puncture procedure ( < 0.05).

CONCLUSION

The sensitivity, specificity, and diagnostic accuracy of lesion size and type in the CEUS group were higher than those in the US group.

摘要

背景

局灶性肝脏病变(FLL)是一种常见的肝脏疾病形式,需要确定准确的病理类型以指导治疗和评估预后。

目的

比较和分析超声造影(CEUS)与常规超声(US)在局灶性肝脏病变临床诊断中的应用效果。

材料和方法

回顾性分析 2015 年 12 月至 2021 年 8 月我院收治的 682 例肝脏占位性病变患者,其中 280 例行 CEUS 引导活检,402 例行常规 US 活检,比较两组活检结果。还分析了活检成功率和准确率及其与不同病理特征的关系。

结果

CEUS 组的活检成功率、灵敏度、诊断准确率、阳性预测值和阴性预测值均明显高于 US 组( < 0.05)。CEUS 组的病灶大小准确率明显高于 US 组(89.29%比 40.55%; < 0.05)。CEUS 组的病灶类型准确率明显高于 US 组(86.49%比 43.59%),两组间差异有统计学意义( < 0.05)。Logistic 回归分析表明,恶性病变、病灶≥5 cm 和病灶≤1 cm 是影响穿刺成功率的独立因素( < 0.05)。

结论

CEUS 组在病灶大小和类型的灵敏度、特异性和诊断准确率方面均高于 US 组。

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