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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Differentiation of benign from malignant focal splenic lesions using sulfur hexafluoride-filled microbubble contrast-enhanced pulse-inversion sonography.
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Differentiation of benign from malignant focal splenic lesions using sulfur hexafluoride-filled microbubble contrast-enhanced pulse-inversion sonography.

机译：使用六氟化硫填充的微泡造影增强脉冲倒置超声检查技术区分良性和恶性局灶性脾脏病变。

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OBJECTIVE: The purpose of our study was to evaluate whether sonographic characterization of focal splenic lesions could be improved by using low mechanical index pulse-inversion sonography after sulfur hexafluoride-filled microbubble injection. MATERIALS AND METHODS: One hundred forty-seven splenic lesions (68 benign, 79 malignant) in 147 patients (81 men, 66 women; mean age, 51 years) underwent baseline gray-scale sonography and sulfur hexafluoride-enhanced low-acoustic-power pulse-inversion sonography (mechanical index < 0.1). Two site investigators assessed in consensus lesion and splenic enhancement during arterial and parenchymal phases. Four readers (readers 1 and 2, blinded; and readers 3 and 4, unblinded to clinical data) independently reviewed baseline and contrast-enhanced sonograms and provided confidence rating for diagnosis of malignancy or benignancy. Accuracy, sensitivity, specificity, positive and negative predictive values, and areas under the receiver operating characteristic curves (A(z)) were calculated by considering biopsy results or splenectomy (51 patients) or CT or MR images followed by serial sonography 6-12 months apart (96 patients) as reference standards. RESULTS: Benign lesions appeared predominately non- or isoenhancing relative to splenic parenchyma, whereas malignant lesions appeared predominately progressively hypoenhancing. For correct diagnosis of benignancy or malignancy, review of contrast-enhanced sonography after baseline sonography yielded significantly improved diagnostic performance (overall accuracy, 51%, 43%, 70%, and 74% before vs 83%, 81%, 92%, and 91% after contrast-enhanced sonography for readers 1, 2, 3, and 4; p < 0.05; respectively) and significantly improved diagnostic confidence (A(z), 0.770, 0.678, 0.900, and 0.917 before vs 0.935, 0.917, 0.984, and 0.959 after contrast-enhanced sonography for readers 1, 2, 3, and 4; p < 0.05; respectively). CONCLUSION: Sulfur hexafluoride-filled microbubble-enhanced sonography improves characterization of focal splenic lesions with and without the availability of clinical data.
机译：目的：本研究的目的是评估六氟化硫填充微泡后使用低机械指数脉冲反转超声可以改善局灶性脾脏病变的超声特征。材料与方法：对147例患者（男81例，女66例;平均年龄51岁）中的147例脾脏病变（68例良性，79例恶性）进行了基线灰度超声检查，六氟化硫增强了低声功率脉冲反转超声检查（机械指数<0.1）。两名现场调查员评估了动脉期和实质期的共识性病变和脾脏增强。四个阅读器（对临床数据不知情的阅读器1和2，以及对临床数据不知情的阅读器3和4）独立地检查了基线和对比增强的超声图，并提供了诊断恶性或良性的置信度。通过考虑活检结果或脾切除术（51例患者）或CT或MR图像，然后进行连续超声检查，计算出准确性，敏感性，特异性，阳性和阴性预测值以及接受者操作特征曲线下的面积（A（z））（6-12）间隔月（96例患者）作为参考标准。结果：相对于脾实质，良性病变主要表现为非增强或等增强，而恶性病变则主要表现为逐渐增强。为了正确诊断良性或恶性，在基线超声检查后进行超声造影检查可以显着改善诊断性能（总准确率分别为51％，43％，70％和74％，而之前的准确率为83％，81％，92％和对比增强的超声检查后，分别对阅读器1、2、3和4进行超声检查的患者为91％; p <0.05;分别显着提高了诊断的置信度（A​​（z），0.770、0.678、0.900和0.917，而0.935、0.917、0.984之前） ，以及分别对阅读器1、2、3和4进行超声造影后的0.959; p <0.05;）。结论：无论有无临床数据，六氟化硫填充的微泡超声检查可改善局灶性脾损伤的特征。

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