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目的探讨超声造影(CEUS)与声辐射力脉冲成像技术(ARFI)在肝脏良恶性肿瘤鉴别诊断中的临床应用价值。方法对202例253个病灶经病理确诊的肝肿瘤(原发性肝癌60例,转移性肝癌40例,肝内胆管细胞癌18例,肝血管瘤50例,局灶性结节性增生16例,肝硬化增生结节18例)分别进行CEUS及ARFI检查。采用双盲法分析两种超声技术对肝脏良恶性肿瘤的诊断价值。结果 CEUS诊断肝脏肿瘤良恶性的灵敏度、特异度、准确度分别为88.96%、88.89%、88.93%。ARFI诊断肝脏肿瘤良恶性的灵敏度、特异度、准确度分别为79.31%、75.93%、77.89%。CEUS联合ARFI诊断肝脏肿瘤良恶性的灵敏度、特异度、准确度分别为91.72%、92.59%、92.09%。结论 CEUS对肝肿瘤良恶性的鉴别诊断优于ARFI;但两种技术联合应用可提高肝脏良恶性病灶的鉴别诊断,降低漏诊率和误诊率。
Objective To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) and acoustic radiation pulse imaging (ARFI) in the differential diagnosis of benign and malignant liver tumors. Methods Two hundred and twenty-two 253 pathologically confirmed liver tumors (60 primary liver cancer, 40 metastatic liver cancer, 18 intrahepatic cholangiocarcinoma, 50 hepatic hemangioma, and 16 patients with focal nodular hyperplasia , Cirrhosis and nodules in 18 cases) were CEUS and ARFI. Double-blind analysis of two kinds of ultrasound in the diagnosis of benign and malignant liver tumors. Results The sensitivity, specificity and accuracy of CEUS in the diagnosis of benign and malignant liver tumors were 88.96%, 88.89% and 88.93%, respectively. The sensitivity, specificity and accuracy of ARFI in diagnosing benign and malignant liver tumors were 79.31%, 75.93% and 77.89%, respectively. The sensitivity, specificity and accuracy of CEUS combined with ARFI in the diagnosis of benign and malignant liver tumors were 91.72%, 92.59% and 92.09%, respectively. Conclusion CEUS is superior to ARFI in the differential diagnosis of benign and malignant hepatic tumors. However, the combination of the two techniques can improve the differential diagnosis of benign and malignant lesions in the liver and reduce the rate of misdiagnosis and missed diagnosis.