摘要
目的 探讨超声造影鉴别诊断胰腺囊实性病变的临床应用价值.方法 对88例胰腺囊实性病变患者行常规超声和超声造影检查,由两位不同年资超声医师独立阅片,应用ROC曲线评估常规超声和超声造影判断胰腺囊实性病变良恶性的诊断价值,Kappa值评估不同年资超声医师之间的一致性.结果 90个病灶中胰腺囊肿5个,胰腺假性囊肿14个,胰腺浆液性囊腺瘤14个,胰腺黏液性囊腺瘤11个,胰腺癌合并液化13个,胰腺实性假乳头状瘤12个,慢性胰腺炎11个,胰腺导管内乳头状瘤2个,胰腺神经内分泌瘤3个,胰腺囊腺癌、成人胰母细胞瘤、胰腺淋巴瘤、胰腺肉瘤样癌、胰腺神经内分泌癌各1个.常规超声和超声造影对具体病变的正确诊断率在年资高者为36.7％和65.5％（P＜0.05）,在年资低者为20.0％和53.3％（P＜0.05）.受试者之间的一致性超声造影较常规超声高,Kappa值分别为0.654±0.095和0.464±0.075.年资低者和年资高者ROC曲线下面积在常规超声为0.670和0.832,在超声造影为0.902和0.919.结论 与常规超声比较,超声造影能显著提高胰腺囊实性病变的鉴别诊断率.
Objective To explore the clinical application value of contrast-enhanced ultrasound in the differential diagnosis of pancreas solid-cystic lesions.Methods Baseline ultrasound （BUS） and contrastenhanced ultrasound （CEUS） were adopted to detect 88 patients with pancreatic solid-cystic lesions,two different seniority ultrasonic doctors read the images separately,ROC curve was used to evaluate the diagnostic value of BUS and CEUS in the diagnosis of benign or malignant pancreatic solid-cystic lesions,and the diagnostic consistency among different seniority ultrasonic doctors was evaluated by Kappa statistics.Results Among the ninety lesions,there were pancreatic cyst five cases,pancreatic pseudocyst fourteen cases,pancreatic serous cystadenoma fourteen cases,pancreatic mucinous cystadenoma eleven cases,pancreatic carcinoma combined liquefied thirteen cases,solid-pseudopallary tumor of pancreas twelve cases,chronic pancreatitis eleven cases,pancreatic intraductal papilloma two cases,pancreatic neuroendocrine tumor three cases,pancreatic cystadenocarcinoma,pancre-atoblatoma,pancreas lymphoma,Sarcomatoid carcinoma of the pancreas,pancreatic neuroendocrine carcinoma one case,respectively.The correct diagnosis rate of specific disease was 36.7% by BUS （P 〈0.05）,65.5% by CEUS to senior doctors,and 20.0% by BUS,53.3% by CEUS to junior doctors （P 〈0.05）.The consistency of experimenters in CEUS was higher than in BUS,the Kappa value was 0.654 ±0.095 and 0.464 ± 0.075 respectively.The areas under the ROC curve （Az） were 0.670 by BUS,0.832 by CEUS to junior doctors,and 0.902 by BUS,0.919 by CEUS to senior doctors.Conclusions Compared with BUS,CEUS can significantly enhance the diagnostic rate of pancreatic solid-cystic lesions.
出处
《中华超声影像学杂志》
CSCD
北大核心
2014年第10期869-874,共6页
Chinese Journal of Ultrasonography
基金
国家自然科学基金（81371555）
关键词
超声检查
微气泡
胰腺疾病
诊断
鉴别
Ultrasonography
Microbubbles
Pancreatic diseases
Diagnosis,differential
