超声造影时间-强度曲线相关参数诊断不同肝脏占位性病变性质效能分析*

doi:10.3969/j.issn.1672-5069.2026.01.033

摘要/Abstract

摘要： 目的分析超声造影(CEUS)时间-强度曲线(TIC)相关参数与影像报告和数据系统(LI-RADS)诊断肝脏占位性病变性质的效能,以期为临床提供可靠的影像学依据,优化肝脏占位性病变的早期诊断策略。方法 2020年1月～2024年12月我院收治的肝脏占位性病变患者82例,经穿刺或手术后组织病理学检查诊断。所有患者接受CEUS检查,记录造影剂峰值强度、达峰时间、上升时间、渡越平均时间和血流灌注指数,并予以LI-RADS分类,以LR-4a为诊断良恶性的截断点。结果在82例肝脏占位性病变中,组织病理学检查诊断恶性病变43例(52.4%)和良性病变39例 (47.6%);恶性病变峰值强度和渡越平均时间分别为(126.2±15.7)%和(126.8±26.0)s,均显著低于或快于良性病变【分别为(140.5±18.4)%和(246.6±42.6)s,P<0.05】,而达峰时间、上升时间和血流灌注指数分别为(21.4±3.9)s、(34.4±6.3)s和(85.2±14.6),均显著慢于或大于良性病变【分别为(17.3±3.2)s、(30.3±5.6)s和(50.4±7.8),P<0.05】;LI-RADS分类诊断假阴性6例(13.9%),假阳性4例(10.2%); CEUS定量参数综合诊断肝脏占位性病变性质的敏感性为95.3%(41/43),特异性为84.6%(33/39),而LI-RADS分类诊断的敏感性为86.0%(37/43),特异性为89.7%(35/39)。结论 CEUS TIC量化参数和LI-RADS分类鉴别诊断肝脏占位性病变性质具有较高的临床应用价值,值得深入研究。

关键词: 肝细胞癌, 局灶性结节性增生, 超声造影, 时间-强度曲线, 影像报告和数据系统, 诊断

Abstract: Objective The aim of this study was to investigate the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) time-intensity curve (TIC) parameters and liver imaging reporting and data system (LI-RADS) classification in differentiating diagnosis of liver space-occupying lesions (SOL). Methods 82 patients with liver SOL were encountered in our hospital between January 2020 and December 2024, and the diagnosis was proven by liver histo-pathological examination. All patients underwent CEUS to record TIC parameters, including peak intensity, time to peak, rise time, mean transit time and blood flow perfusion index. Intrahepatic lesions were classified according to LI-RADS criteria, with LR-4a as the cut-off value, e.g., LR-1 to LR-4a were classified as benign, and LR-4b to LR-5 were defined as malignant lesions. Results Of the 82 patients with liver SOL, liver histo-pathological examination found malignant lesions in 43 cases (52.4%), and benign ones in 39 cases (47.6%); peak intensity and mean transit time in malignant lesions were(126.2±15.7)% and (126.8±26.0)s, both significantly lower or faster than [(140.5±18.4)% and (246.6±42.6)s, respectively, P<0.05], while time to peak, rise time and blood flow perfusion index were (21.4±3.9)s, (34.4±6.3)s and (85.2±14.6), all much slower or greater than [(17.3±3.2)s, (30.3±5.6)s and (50.4±7.8), respectively, P<0.05] in benign lesions; false negative false positive rates by LI-RADS diagnosis was 13.9% and 10.2%; the sensitivity and specificity by CEUS quantitative parameters were 95.3%(41/43) and 84.6%(33/39), and they were 86.0%(37/43)and 89.7%(35/39) by LI-RADS. Conclusion Both the quantitative parameters of CEUS TIC and the LI-RADS classification demonstrate satisfactory diagnostic performance in distinguishing benign from malignant liver SOL, which warrants further clinical investigation.

Key words: Hepatoma, Focal nodular hyperplasia, Contrast enhanced ultrasound, Time-intensity curve, Liver imaging reporting and data system, Diagnosis

陈然, 张婷婷, 朱佳琪, 邓艳峰. 超声造影时间-强度曲线相关参数诊断不同肝脏占位性病变性质效能分析^*[J]. 实用肝脏病杂志, 2026, 29(1): 129-132.

Chen Ran, Zhang Tingting, Zhu Jiaqi, et al. Diagnostic efficacy of contrast-enhanced ultrasound time-intensity curve parameters in differentiating diagnosis of liver space-occupying lesions[J]. Journal of Practical Hepatology, 2026, 29(1): 129-132.

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超声造影时间-强度曲线相关参数诊断不同肝脏占位性病变性质效能分析^*

Diagnostic efficacy of contrast-enhanced ultrasound time-intensity curve parameters in differentiating diagnosis of liver space-occupying lesions

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