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1、嶺南現(xiàn)代If缶床外科2014年8月第l4卷第4期LingnanModemClinicsinSurgery.Au2014.Vo1.14No.4353超聲造影對非肝細胞癌肝臟局灶性病變的診斷價值嚴燕瓊謝曉燕鄭榮琴李安華羅葆明【摘要】目的探討超聲造影(CEUS)對非肝細胞癌肝臟局灶性病變的診斷價值。方法對1753例行CEUS的非肝細胞癌肝臟局灶性病變患者的超聲造影進行回顧分析,將超聲造影結(jié)果與診斷金標準對比,評價CEUS對非肝細胞癌肝臟局灶性病變良惡性及病灶類型區(qū)分的診斷價值。結(jié)果1753病例中,良性病灶1318個、CEUS正確診斷92.94%(1225/1
2、318);惡性病灶435個,CEUS正確診斷88.74%(386/435);CEUS對非肝細胞癌肝臟局灶性惡性病變診斷的敏感度為88.74%(386/435),特異度為92.94%(1225/1318),準確率為91.9o%(1611/1753),陽性預(yù)測值為8O.58.7%(386/479),陰性預(yù)測值為96.15%(1225/1274)。CEUS對不同病灶病理類型診斷的準確率:血管瘤97.41%(640/657)、局灶性脂肪變96.43%(216/224)、MLC84.81%(268/316)、FNH85.55%(225/263)、炎性病變(包括肝
3、膿腫)58.82%(40/68)、RN57.14%(28/49)、DN12.50%(2/16)。結(jié)論CEUS對非肝細胞癌肝臟局灶性病變的良惡性鑒別診斷有較高的價值,但對病種類型的定性診斷準確率有待提高。【關(guān)鍵詞】非肝細胞癌肝臟局灶性病變;超聲造影;診斷價值中圖分類號:R445.1文獻標識碼:A文章編號:1009—976X(2014)04—0353—05doi:10.3969/j.issn.1009—976X.2014.04.001Diagnosticvalueofnon--hepatocellularcarcinomafocalLiverlesions
4、bycontrast--enhancedultrasoundYonYanqion~,XieXiaoyanb,ZhengRongqi~,LiAnhua~,LuoBooming.DepartmentofultrasonographyaLecongHospitalofShunde,F(xiàn)oshan528315;TheFirst&giliatedHosphdofSunYat—senUnwe~,Guangzhou510080;TheThirdA.f~liatedHospitalofSunYat一8erl,Umvers,Guangzhou510630;TheAfili
5、atedTumorHo~italofSunYat-selgUnwem】,Guangzhou510060;"SunYat—senMemorialHo~ital,Guangzhou510120,China.Correspondingauthor:LuoBooming,bmluo2005@l26.com【Abstract】ObjectiveToexplorethevalueofcontrast-enhancedultrasound(CEUS)indiagnosisofnon—hepatocellularcarcinoma(HCC)focalliverlesi
6、on(FEE).MethodsCEUScharacterizationsof1753caseswithnon—HCCFLLwereretrospectivelyanalyzed.A11caseswleIecomparedtothegoldstandardandcollectedfromfourhospitals.ThediagnosticvalueofCEUSdiferentiatingnon—HCCFLLWaSevaluatedbetweenbenignandmalignanttumor,anddiferenttypeoflesionwereeval
7、uated.ResultsIn1753non.HCCFLL。1318caseswerebenignlesions,ofwhich92.94%(1225/1318)benignlesionswerediagnosedcorrectlybyCEUS;435casesweremalignantlesions,ofwhich88.74%(386/435)malignantlesionswerediagnosedcorrectlybyCEUS.Thesensitivity,specificity,accuracyrate.positivepredictiveva
8、lueandnegativepredictivevalueofCEUSwere88.74%(3