肝脏彩超血流参数联合超声造影鉴别良恶性肝脏局灶性病变的价值

肝脏 ›› 2026, Vol. 31 ›› Issue (7): 980-983.

肝脏彩超血流参数联合超声造影鉴别良恶性肝脏局灶性病变的价值

陈显燕, 周静, 邓家琦, 谭春梅, 余显梅, 杜健

646200 泸州西南医科大学附属医院合江县人民医院超声医学科(陈显燕,谭春梅,余显梅,杜健);
646000 泸州西南医科大学附属医院超声医学科(周静,邓家琦)

收稿日期:2025-09-11 出版日期:2026-07-31 发布日期:2026-08-21
通讯作者: 周静,Email:726874621@qq.com
基金资助:
泸州市科技计划项目(No.2021-JYJ-79)

The value of a combined use of color Doppler ultrasound blood flow parameters and contrast-enhanced ultrasound in differentiating benign and malignant hepatic focal lesions

Chen Xianyan¹, Zhou Jing², Deng Jiaqi², Tan Chunmei¹, Yu Xianmei¹, Du Jian¹

1. Department of Ultrasound Medical, Southwest Medical University Affiliated Hospital Hejiang Hospital, Hejiang County People′s Hospital, Luzhou 646200, China;
2. Department of Ultrasound Medical, the Affiliated Hospital of Southwest Medical University, Luzhou 646000,China

Received:2025-09-11 Online:2026-07-31 Published:2026-08-21
Contact: Zhou Jing,Email:726874621@qq.com

摘要/Abstract

摘要： 目的探讨肝脏彩色多普勒超声(CDUS)血流参数联合超声造影(CEUS)参数鉴别良恶性肝脏局灶性病变的价值。方法选取2022年1月至2025年1月本院收治的经病理确诊的126例肝脏局灶性病变患者,根据病理检查结果分为良性组和恶性组。患者均接受彩色CDUS检测和CEUS检测,比较两组患者的血流参数[阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)]和超声造影参数[达峰时间(TTP)、峰值强度(PI-CEUS)、增强时间(ET)、增强斜率(ES)]。采用多因素logistic回归分析筛选恶性病变的独立危险因素,并通过ROC曲线评估CDUS联合CEUS鉴别良恶性病变的诊断效能。结果本研究126例肝脏局灶性病变患者中,恶性病变占比54.76%(69/126)。恶性组RI、PI、PSV、PI-CEUS、ES分别为0.88±0.30、1.70±0.41、(21.09±3.60)cm/s、(28.70±3.26)dB、1.82±0.57,均显著高于良性组,TTP、ET分别为(26.22±3.09)s、(19.61±2.80)s,显著低于良性组(均P<0.05)。Logistic回归分析显示:RI、PSV、ES升高是恶性病变的独立危险因素(OR>1, P<0.05),TTP、ET升高是其独立保护因素(OR<1, P<0.05)。ROC曲线分析表明:CDUS联合CEUS鉴别良恶性病变的灵敏度为91.3%、特异度为98.2%、曲线下面积为0.974。结论 CDUS血流参数联合CEUS灌注参数可有效鉴别良恶性肝脏局灶性病变,为临床诊断提供了可靠依据。

关键词: 肝脏局灶性病变, 良恶性, 彩色多普勒超声, 超声造影, 诊断效能

Abstract: Objective To investigate the value of combining color Doppler ultrasonography (CDUS) blood flow parameters with contrast-enhanced ultrasonography (CEUS) parameters in differentiating benign from malignant hepatic focal lesions. Methods A total of 126 patients with histopathologically confirmed hepatic focal lesions admitted to our hospital from January 2022 to January 2025 were selected. The patients were divided into a benign group and a malignant group based on their pathological findings. All patients underwent both CDUS and CEUS examinations. Blood flow parameters and CEUS parameters were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for malignant lesions, and the diagnostic efficacy of combining CDUS with CEUS in differentiating benign from malignant lesions was evaluated using receiver operating characteristic (ROC) curves. Results In this study, among 126 patients with focal liver lesions, malignant lesions accounted for 54.76% (69/126). In the malignant group, the resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), perfusion index in contrast-enhanced ultrasound (PI-CEUS), and enhancement slope (ES) were 0.88±0.30, 1.70±0.41, (21.09±3.60) cm/s, (28.70±3.26) dB, and 1.82±0.57 respectively, all of which were significantly higher than those in the benign group. The time to peak (TTP) and enhancement time (ET) in the malignant group were (26.22±3.09) seconds and (19.61±2.80) seconds respectively, which were significantly lower than those in the benign group (all P<0.05). Logistic regression analysis showed that increased RI, PSV, and ES were independent risk factors for malignant lesions (OR>1, P<0.05), while increased TTP and ET were independent protective factors (OR<1, P<0.05). Receiver operating characteristic (ROC) curve analysis indicated that the sensitivity, specificity, and area under the curve (AUC) of combined conventional Doppler ultrasound (CDUS) and contrast-enhanced ultrasound (CEUS) for differentiating benign and malignant lesions were 91.3%, 98.2%, and 0.974, respectively. Conclusion Combining CDUS blood flow parameters with CEUS perfusion parameters can effectively differentiate benign from malignant hepatic focal lesions, thus providing a reliable basis for clinical diagnosis.

Key words: Hepatic focal lesions, Benign and malignant, Color doppler ultrasound, Contrast-enhanced ultrasound, Diagnostic efficacy

陈显燕, 周静, 邓家琦, 谭春梅, 余显梅, 杜健. 肝脏彩超血流参数联合超声造影鉴别良恶性肝脏局灶性病变的价值[J]. 肝脏, 2026, 31(7): 980-983.

Chen Xianyan, Zhou Jing, Deng Jiaqi, Tan Chunmei, Yu Xianmei, Du Jian. The value of a combined use of color Doppler ultrasound blood flow parameters and contrast-enhanced ultrasound in differentiating benign and malignant hepatic focal lesions[J]. Chinese Hepatolgy, 2026, 31(7): 980-983.

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