摘要
目的:分析超声造影(CEUS)联合功能性磁共振成像(fMRI)对肝脏结节性病变性质早期鉴别诊断的价值。方法:选取医院收治的82例肝脏结节性病变患者,均行CEUS及fMRI检查,以活检或术后病理学检查结果为金标准,采用四格表分析CEUS、fMRI单项及二者联合检查对肝脏结节性病变的诊断价值。结果:活检或术后病理学检查结果显示,82例患者共检出病灶88个,其中良性病变患者51例,病灶数54个,恶性病变患者31例,病灶数34个。以活检或病理学检查结果为金标准,四格表分析CEUS诊断肝脏结节性良恶性病变的灵敏度为79.63%,特异度为82.35%,准确度为80.68%,Kappa值为0.603;fMRI诊断肝脏结节性良恶性病变的灵敏度为83.33%,特异度为85.29%,准确度为84.09%,Kappa值为0.672;二者联合诊断肝脏结节性良恶性病变的灵敏度为94.44%,特异度为91.18%,准确率为93.18%,Kappa值为0.856,均优于单项检测,准确率比较差异有统计学意义(x2=5.683,P<0.05)。结论:CEUS及fMRI对肝脏结节性病变性质有一定鉴别诊断价值,二者联合可提高诊断灵敏度和准确度,更具临床应用价值。
Objective:To analyze the value of contrast-enhanced ultrasound(CEUS)combined with functional magnetic resonance imaging(fMRI)in the early differential diagnosis of lesions nature of liver nodule.Methods:82 patients with lesions on liver nodule were selected,and all of them underwent CEUS and fMRI examination.The results of biopsy or postoperatively pathological examinationy were used as the golden standard,and the diagnostic values of CEUS,fMRI and the combination of CEUS and fMRI for the lesions of liver nodule were analyzed by fourfold table.Results:The results of biopsy or postoperatively pathological examination showed that 88 lesions were detected in 82 patients.Among of them,51 cases with 54 lesions were benign,and 31 cases with 34 lesions were malignant.The results of biopsy or pathology were used as the golden standard,and the analysis of four-fold table showed that the sensitivity,specificity,accuracy and Kappa value of CEUS diagnosis for benign and malignant lesions of liver nodule were 79.63%,82.35%,80.68%and 0.603 respectively.And the sensitivity,specificity,accuracy and Kappa value of fMRI diagnosis for benign and malignant lesions of liver nodule were 83.33%,85.29%,84.09%and 0.672 respectively.And the sensitivity,specificity,accuracy and Kappa value of the combined diagnosis of the two methods for benign and malignant lesions of liver nodule were 94.44%,91.18%,93.18%and 0.856 respectively,which of them were superior to single detection,while the difference of accuracy between different methods was statistically significant(x2=5.683,P<0.05).Conclusions:CEUS and fMRI have a certain of value in the differential diagnosis of lesion nature of liver nodule,and the combination of the two methods can increase diagnostic sensitivity and accuracy,and it has more clinical application value.
作者
罗丽
张威
卢漫
吴晓波
任静
何发伟
LUO Li;ZHANG Wei;LU Man(Department of Ultrasound,Jinjiang Maternity and Child Health Hospital,Chengdu 610041,China)
出处
《中国医学装备》
2020年第12期84-88,共5页
China Medical Equipment
基金
四川省卫计委科研课题(17PJ515)“功能磁共振测定肝细胞铁含量鉴别诊断肝癌相关结节的研究”。
