超声弹性成像联合超声造影在鉴别原发性及转移性肝癌中的应用

为探讨超声弹性成像联合超声造影在鉴别原发性及转移性肝癌中的应用价值,选择2016年12月至2018年12月期间本院消化外科住院部收治的肝癌患者160例作为研究对象,根据病理组织学检查结果将患者分为原发组和转移组,各80例,两组进行超声弹性成像和超声造影检查,分析单项和两者联合检查对原发性及转移性肝癌的鉴别诊断效能。结果显示,原发组超声弹性成像评分(3.41±0.85)分,明显高于转移组的(1.52±0.62)分,两组比较差异具有统计学意义,P<0.05。与转移组相比较,原发组造影峰值时间明显延长,造影始增时间明显缩短,造影峰值增强速率明显降低,两组比较差异具有统计学意义(P<0.05)。两者联合检查对原发性及转移性肝癌的鉴别诊断灵敏度、特异度、阳性预测值、阴性预测值、准确度高于超声弹性成像或超声造影单项检查,漏诊率和误诊率低于超声弹性成像或超声造影单项检查,两者联合检查对原发性及转移性肝癌的鉴别诊断准确度明显高于超声造影单项检查,P<0.05。说明超声弹性成像联合超声造影有利于明显提高原发性及转移性肝癌的鉴别诊断准确度,值得临床推广应用。

Application of Ultrasound Elastography Combined Contrast-enhanced Ultrasoundin Differential Diagnosis of Primary and Metastatic Liver Cancer

To investigate the application value of ultrasound elastography combined contrast-enhanced ultrasound in differential diagnosis of primary and metastatic liver cancer, 160 cases of liver cancer patients admitted to digestive surgery inpatient department of our hospital from December 2016 to December 2018 were selected as study subjects. According to the results of histopathological examination, the patients were divided into primary group and metastatic group, 80 cases in each. Ultrasound elastography and contrast-enhanced ultrasonography were examination for the two groups.The differential diagnosis efficacy of single examination and combined examination for primary and metastatic liver cancer were analyzed. The score of ultrasound elastography in primary group (3.41±0.85) was significantly higher than that in metastatic group (1.52 ±0.62), and the difference between the two groups was statistically significant (P<0.05).Compared with metastatic group, contrast peak time was significantly prolonged, contrast onset time was significantly shortened, contrast peak enhancement rate was significantly reduced while compared with primary group(P<0.05).The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both combined examination were higher than ultrasound elastography or contrast-enhanced ultrasound single examination, miss-diagnosis and misdiagnosis rates were lower than ultrasound elastography or contrast-enhanced ultrasound single examination,the accuracy of both combined examination was significantly higher than contrast-enhanced ultrasound single examination in differential diagnosis of primary and metastatic liver cancer, P< 0.05.Conclusion:Ultrasound elastography combined contrast-enhanced ultrasound can significantly improve differential diagnosis accuracy of primary and metastatic liver cancer, it is worthy of clinical application.