摘要
目的评估超声造影诊断肝复杂囊性病变的应用价值。方法65例患者中的67个肝复杂囊性病变接受了普通超声和超声造影检查，两位超声医师（一位年资高者和一位年资低者）独立阅片，应用ROC曲线评估普通超声和超声造影判断肝复杂囊性病变良恶性的诊断价值，Kappa值检验评估年资高及年资低者之间的一致性。结果ROC曲线显示年资高者和年资低者得到的曲线下面积在普通超声分别为0．917和11．774（P=0．044），在超声造影分别为0．935和0．922（P=0．420）。普通超声和超声造影的曲线下面积在年资高者差异无统计学意义（0.917对0．935，P=0．380），在年资低者差异有统计学意义（0．774对0．922，P=0．047）。超声造影明显提高了诊断肝复杂囊性病变良恶性的特异性、准确性和阳性预测值（均P〈0．01）。普通超声和超声造影对具体病变的正确诊断率在年资高者分别为26．9％（18／67）和76．1％（51／67），在年资低者分别为28．4％（19／67）和58．2％（39／67）（均P〈0.001）。受试者之间的一致性超声造影较普通超声高，Kappa值分别为0．774（95％置信区间：0．688～0.860）和0．325（95％置信区间：0．214～0．436）。结论与普通超声相比，超声造影显著提高了鉴别诊断肝复杂囊性病变良恶性的能力和对具体病变的诊断能力，并且提高了观察者间的一致性。
Objective To evaluate the diagnostic performance of real-time contrast enhanced ultrasound （CEUS） in characterizing complex cystic focal liver lesions（FLLs）. Methods Sixty seven complex cystic FI.Ls in 65 patients were examined with baseline ultrasound（BUS） and CEUS. BUS and CEUS images were reviewed by a resident radiologist and a staff radiologist independently. Diagnostic performance was evaluated using receiver operating characteristic（ROC） analysis and the interobserver agreement was analyzed by weighted κ statistics. Results After ROC analysis,the areas under the ROC curve（Az） were 0. 917 for the staff radiologist and 0. 774 （ P = 0.044） for the resident radiologist on BUS,and were 0. 935 and 0. 922（ P = 0.42） on CEUS. A significant difference in Az between BUS and CEUS was found for the resident radiologist （0. 774 versus 0. 922, P = 0. 047）, whereas not found for the staff radiologist （0. 917 versus 0. 935, P = 0.38）. Better results of specific diagnosis were obtained on CEUS [28.4% （19/67） before versus 58.2% （39/67） after review of CEUS images for resident radiologist, and 26.9% （18/67） versus 76.1G （51/67） for staff radiologist, both P〈0.001]. Interobserver agreement was improved after review of CEUS images [κ= 0. 325 （95% confidence interval： 0. 214-0. 436） on BUS versus κ= 0. 774 （95G confidence interval：0.6884）. 860） on CEUS]. Conelusions Real time CEUS improves the capability of discrimination between malignant and benign lesions and specific characterization for complex cystic FLLs,as well as the interobserver agreement.
出处
《中华超声影像学杂志》
CSCD
北大核心
2009年第1期41-45,共5页
Chinese Journal of Ultrasonography
基金
基金项目：教育部新世纪优秀人才支持计划项目（NCET06-0723）
关键词
超声检查
微气泡
肝疾病
ROC曲线
Ultrasonograpby
Microbubbles
Liver diseases
ROC curve
