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  • 梅将军,宋烨,张夏静,等.超声造影定量分析在胆囊息肉样病变诊断中的价值[J].同济大学学报(医学版),2021,42(4):489-494.    [点击复制]
  • MEI Jiang-jun,SONG Ye,ZHANG Xia-jing,et al.Quantitative analysis of contrast-enhanced ultrasound in diagnosis of polypoid lesions of gallbladder[J].同济大学学报(医学版),2021,42(4):489-494.   [点击复制]
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超声造影定量分析在胆囊息肉样病变诊断中的价值
梅将军,宋烨,张夏静,马瑛,胡利华,项伟
0
(上海健康医学院附属周浦医院超声科,上海201318;上海市浦东新区浦南医院病理科,上海200125)
摘要:
目的探讨超声造影(contrast-enhanced ultrasound, CEUS)定性结合定量分析在胆囊肿瘤性息肉样病变诊断中的应用价值。方法回顾性分析2018年7月—2019年10月经上海市浦东新区周浦医院手术病理证实的33例胆囊息肉样病变患者(息肉直径≥1cm)。所有患者术前均接受常规超声和CEUS检查,使用时间-强度曲线对CEUS结果进行定量分析,并利用受试者工作特征曲线(receiver operating characteristic, ROC)评价CEUS的诊断效能。结果根据胆囊切除术后病理结果分为非肿瘤性息肉组(n=16)和肿瘤性息肉组(n=17)。CEUS定性分析显示肿瘤性息肉囊壁不连续,两组间差异具有统计学意义(P<0.001)。CEUS定量评估表明,非肿瘤性息肉组的上升时间、平均通过时间、达峰时间和消退时间均明显短于肿瘤性息肉组(P<0.001,P=0.008、P=0.013、P=0.002)。CEUS定量参数鉴别两组的灵敏度和特异度分别为90%和75%,ROC曲线下面积为0.775~0.892。CEUS定性分析诊断肿瘤性与非肿瘤性息肉准确率为66.7%(22/33),两者结合诊断准确率为87.9%(29/33)。结论超声造影定性结合定量分析有助于提高胆囊肿瘤性息肉样病变的诊断准确率。
关键词:  胆囊息肉样病变  超声造影  定量分析  鉴别诊断  灵敏度
DOI:10.12289/j.issn.1008-0392.20310
投稿时间:2020-07-21
基金项目:上海市浦东新区卫计委领先人才(PWRI2019-06)
Quantitative analysis of contrast-enhanced ultrasound in diagnosis of polypoid lesions of gallbladder
MEI Jiang-jun,SONG Ye,ZHANG Xia-jing,MA Ying,HU Li-hua,XIANG Wei
(Dept. of Ultrasonography, Shanghai Unversity of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai 201318, China;Dept. of Pathology, Shanghai Punan Hospital of Pudong New Area, Shanghai 200125, China)
Abstract:
ObjectiveTo evaluate the application of contrast-enhanced ultrasound(CEUS) quanti-tative analysis in diagnosis of neoplastic polypoid lesions of the gallbladder. MethodsClinical data of 33 patients with polypoid lesions(polyp diameter≥1cm) of gallbladder confirmed by operation and pathology in Zhoupu Hospital from July 2018 to October 2019 were analyzed retrospectively. All patients were examined by conventional ultrasound and CEUS before operation. The time-intensity curve was used to quantitatively analyze the results of CEUS, and the receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficiency of CEUS. ResultsAccording to the pathological results after cholecystectomy, it was divided into non-neoplastic polyp group(n=16) and neoplastic polyp group(n=17). Qualitative analysis of CEUS showed that the wall of neoplastic polyps was not continuous, which was different from that of non-neoplastic polyps(P<0.001). CEUS quantitative evaluation showed that the rise time, mean transit time, time to peak intensity and fall time of non-neoplastic gallbladder polyps were significantly shorter than those of neoplastic polyps(P<0.001,0.008,0.013,0.002, respectively). The sensitivity and specificity of the CEUS quantitative parameters to differentiate two groups were 90% and 75%, respectively. The area under the ROC curve was 0.775 to 0.892. The diagnostic accuracy of CEUS qualitative analysis for neoplastic and non-neoplastic polyps was 66.7%(22/33), and the diagnostic accuracy of the combination of qualitative and quantitative ultrasonography was 87.9%(29/33). ConclusionQualitative ultrasound combined with quantitative analysis can improve the accuracy of diagnosis of neoplastic polypoid lesions of the gallbladder.
Key words:  gallbladder polypoid lesions  contrast-enhanced ultrasound  quantitative analysis  differential diagnosis  sensitivity

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