IS HEPATIC ULTRASONOGRAPHY A VALID ALTERNATIVE TOOL TO LIVER-BIOPSY - REPORT ON 507 CASES STUDIED WITH BOTH TECHNIQUES
IS HEPATIC ULTRASONOGRAPHY A VALID ALTERNATIVE TOOL TO LIVER-BIOPSY - REPORT ON 507 CASES STUDIED WITH BOTH TECHNIQUES
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DOI：
10.1007/bf01536033
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发表时间：
1988-04-01
影响因子：
3.1
通讯作者：
DODERO, M
中科院分区：
文献类型：
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作者：
CELLE, G;SAVARINO, V;DODERO, M
为评价肝脏超声检查的诊断价值，对23例正常肝脏、424例慢性广泛性肝病和60例局灶性肝病患者同时行超声检查和肝活检的声像图进行了分析。US在所有肝脏疾病中的阳性预测值良好（范围86.9-96.5%），而其在各种形式的广泛肝脏疾病中的阴性预测值非常低（范围14.1-42.5%），适用于局灶性病变的筛查目的（74%）。在507例患者中，39例超声怀疑肝脏肿块也进行了超声引导细针穿刺，其中27例活检证实为恶性病变的敏感性高（85%），其余12例活检病例中排除了肿瘤细胞。至于US组织诊断，分别在88%、60%和49%的病例中检测到肝肿瘤、脂肪浸润和纤维化。活检的脂肪和纤维含量与回声模式和声衰减相似且显著相关。总体结果表明，在广泛性肝脏疾病组中，如果超声检查正常，患者的实际状况不太可能是阴性，并且不可能区分脂肪和纤维化，则超声的有用性大大降低。在局灶性病变中，US的诊断价值似乎很高，如果对超声引导抽吸物质进行阳性细胞诊断，该方法通常可以提供肿瘤的确凿证据。
In order to evaluate the diagnostic potential of liver ultrasonography (US), the charts of 23 cases with normal liver, 424 patients with chronic widespread, and 60 patients with focal hepatic diseases, who had undergone both US and liver biopsy, were reviewed. The positive predictive value of US was good in all hepatic disorders (range 86.9-96.5%), while its negative predictive value was very low (range 14.1-42.5%) in the various forms of widespread liver disease and suitable for screening purposes (74%)in focal lesions. Of the 507 cases, 39 with an ultrasonically suspected liver mass also underwent an echo-guided fine-needle aspiration, which showed a high sensitivity (85%) in the 27 biopsy-proved malignant lesions and excluded tumor cells in the remaining 12 cirrhotic cases. As regards US tissue diagnosis, hepatic tumors, fatty infiltration, and fibrosis were detected in 88%, 60%, and 49% of cases, respectively. Fat and fibrous content on biopsy were similarly and significantly correlated with both echo pattern and sound attenuation. Overall results suggest that in the group of widespread hepatic disorders the usefulness of US is greatly reduced by the fact that the patient''s actual condition is not likely to be negative if US examination is normal and by the impossibility of differentiating fat from fibrosis. In focal lesions, the diagnostic value of US appears high and the method may frequently provide conclusive proof of the tumor if a positive cytodiagnosis on echoguided aspirated material is done.