目的比较超声造影(CEUS)和普美显磁共振(EOB-MRI)对肝硬化背景下直径≤2 cm肝细胞肝癌(HCC)的诊断效能,探究CEUS动脉期联合EOB-MRI肝胆期对微小肝癌的诊断价值。方法回顾性分析2016年2-12月于天津市第三中心医院收集的98例肝硬化患者共...目的比较超声造影(CEUS)和普美显磁共振(EOB-MRI)对肝硬化背景下直径≤2 cm肝细胞肝癌(HCC)的诊断效能,探究CEUS动脉期联合EOB-MRI肝胆期对微小肝癌的诊断价值。方法回顾性分析2016年2-12月于天津市第三中心医院收集的98例肝硬化患者共113个直径≤2 cm的结节在CEUS和EOB-MRI中的增强模式。以病理诊断或随访作为参考标准,分析CEUS和EOB-MRI对直径≤2 cm HCC的诊断效能。以CEUS动脉期联合EOB-MRI肝胆期作为HCC的诊断标准,探究该诊断标准对直径≤2 cm HCC的诊断价值。结果CEUS和EOB-MRI对HCC单独诊断的ROC曲线下面积分别为0.858、0.814(P>0.05),敏感性为79.1%、81.4%,特异性为92.6%、81.5%,准确性为82.3%、81.4%。以CEUS和EOB-MRI同时诊断HCC作为标准,ROC曲线下面积为0.831,与CEUS和EOB-MRI单独诊断相比差异无统计学意义(0.831对0.858,0.814;均P>0.05),对HCC的诊断敏感性为66.3%,特异性为100%,准确性为74.3%。以CEUS动脉期高增强联合EOB-MRI肝胆期低信号作为诊断标准,ROC曲线下面积为0.934,与CEUS和EOB-MRI单独诊断及CEUS和EOB-MRI同时诊断相比差异有统计学意义(0.934对0.858,0.814,0.831;均P<0.05),对HCC的诊断敏感性为94.2%,特异性为92.6%,准确性为93.8%。结论CEUS动脉期联合EOB-MRI肝胆期对肝硬化背景下微小肝癌的诊断具有较高的敏感性和准确性,可作为在CEUS和EOB-MRI表现为不典型增强模式的微小HCC的新的补充增强模式,有助于HCC的诊断。展开更多
In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid ...In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.展开更多
文摘目的比较超声造影(CEUS)和普美显磁共振(EOB-MRI)对肝硬化背景下直径≤2 cm肝细胞肝癌(HCC)的诊断效能,探究CEUS动脉期联合EOB-MRI肝胆期对微小肝癌的诊断价值。方法回顾性分析2016年2-12月于天津市第三中心医院收集的98例肝硬化患者共113个直径≤2 cm的结节在CEUS和EOB-MRI中的增强模式。以病理诊断或随访作为参考标准,分析CEUS和EOB-MRI对直径≤2 cm HCC的诊断效能。以CEUS动脉期联合EOB-MRI肝胆期作为HCC的诊断标准,探究该诊断标准对直径≤2 cm HCC的诊断价值。结果CEUS和EOB-MRI对HCC单独诊断的ROC曲线下面积分别为0.858、0.814(P>0.05),敏感性为79.1%、81.4%,特异性为92.6%、81.5%,准确性为82.3%、81.4%。以CEUS和EOB-MRI同时诊断HCC作为标准,ROC曲线下面积为0.831,与CEUS和EOB-MRI单独诊断相比差异无统计学意义(0.831对0.858,0.814;均P>0.05),对HCC的诊断敏感性为66.3%,特异性为100%,准确性为74.3%。以CEUS动脉期高增强联合EOB-MRI肝胆期低信号作为诊断标准,ROC曲线下面积为0.934,与CEUS和EOB-MRI单独诊断及CEUS和EOB-MRI同时诊断相比差异有统计学意义(0.934对0.858,0.814,0.831;均P<0.05),对HCC的诊断敏感性为94.2%,特异性为92.6%,准确性为93.8%。结论CEUS动脉期联合EOB-MRI肝胆期对肝硬化背景下微小肝癌的诊断具有较高的敏感性和准确性,可作为在CEUS和EOB-MRI表现为不典型增强模式的微小HCC的新的补充增强模式,有助于HCC的诊断。
基金supported by the Natural Science Foundation of Jiangsu University(14KJB320003)
文摘In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.
