摘要
目的探讨超声造影(CEUS)联合剪切波弹性成像(SWE)对肝硬化背景下肝实质内良恶性结节的鉴别诊断价值。方法选取我院肝硬化患者92例,根据术后病理结果显示,其中恶性结节52例(恶性组),良性结节40例(良性组)。所有患者术前均行CEUS、SWE检查;比较两组CEUS特征及杨氏模量最大值(Emax);分析CEUS、SWE单独及联合诊断恶性结节的效能。结果良、恶性组肝实质内结节动脉相、门脉相及延迟相的CEUS特征比较差异均有统计学意义(均P<0.05),其中恶性组肝实质内结节78.85%呈"快进快出"表现,良性组80.00%呈"慢进慢出"表现。良、恶性组肝实质内结节Emax分别为(36.49±6.12)kPa、(42.36±5.37)kPa,两组比较差异有统计学意义(P<0.05)。CEUS联合SWE诊断肝实质内恶性结节的准确率、敏感性、特异性、阳性预测值、阴性预测值均较CEUS、SWE单独诊断高,差异均有统计学意义(均P<0.05)。结论 CEUS联合SWE有助于提高对肝硬化背景下肝实质内良恶性结节的鉴别诊断价值。
Objective elastography(SWE)in the differential diagnosis of benign and malignant nodules in liver parenchyma under the background of liver cirrhosis.Methods malignant cases(malignant group)and 40 benign cases(benign group).All patients were examined by CEUS and SWE before surgery. CEUS characteristics and maximum Young’s modulus(Emax)were compared between the two groups.The efficacy of CEUS and SWE alone and combined in diagnosing malignant nodules were analyzed.ResultsThere were significant differences in CEUS enhancement characteristics of arterial phase,portal phase,and delayed phase of nodules in liver parenchyma between benign and malignant groups(all P<0.05).78.85% nodules in liver parenchyma in malignant group presented“fast in and fast out”,while 80.00% nodules in the benign group presented“slow in and slow out”. The Emax of nodules in liver parenchyma in benign and malignant groups were(36.49±6.12)kPa and(42.36±5.37)kPa,respectively,and the difference between the two groups was statistically significant(P<0.05). The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of CEUS combined with SWE in the diagnosis of malignant nodules were higher than those of CEUS and SWE alone,there were significant differences(all P<0.05).ConclusionCEUS combined with SWE can improve the value of differential diagnosis of benign and malignant nodules in liver parenchyma under the background of liver cirrhosis.
作者
潘茜
王斯达
PAN Xi;WANG Sida(Department of Ultrasound,the Second People’s Hospital of Guilin,Guangxi 541001,China)
出处
《临床超声医学杂志》
CSCD
2022年第2期119-122,共4页
Journal of Clinical Ultrasound in Medicine
基金
广西自然科学基金项目(2011GXNSFA013312)。
关键词
超声检查
造影剂
剪切波弹性成像
肝硬化
结节
肝实质内
杨氏模量
Ultrasonography
Contrast agent
Shear wave elastography
Liver cirrhosis
Nodules
intrahepaticparenchyma
Young’s modulus
