超声造影在判断脑胶质瘤术肿瘤残留的临床价值-现代医学

超声造影在判断脑胶质瘤术肿瘤残留的临床价值

单位：江苏省淮安市第一人民医院神经外科, 江苏淮安 223300

分类号：R730.264

出版年·卷·期（页码）：2018·46·第二期（149-152）

摘要：

目的：探讨和分析超声造影对脑胶质瘤术肿瘤残留情况诊断敏感性及特异性。方法：选择2012年1月至2016年4月在我院收治确诊的101例脑胶质瘤患者为研究对象，在脑胶质瘤术前术后行常规超声和超声造影检查。结果：与低级别胶质瘤比，高级别胶质瘤上升时间（RT）、达峰时间（TTP）、峰值强度（IMAX）和瘤周水肿均明显增高（P < 0.05）。低级别胶质瘤59例患者中病理检查122处，残余肿瘤20处，非残余肿瘤102处，术中常规超声判断肿瘤残余灵敏度、特异度和准确性分别为70.0%（14/20）、73.9%（68/92）和73.2%（82/112），超声造影分别为90.0%（18/20）、83.7%（77/92）和84.8%（95/112）；高级别胶质瘤42例患者中病理检查82处，残余肿瘤15处，非残余肿瘤67处，术中常规超声判断肿瘤残余灵敏度、特异度和准确性分别为66.7%（10/15）、74.6%（50/67）和73.2%（60/82），超声造影判断肿瘤残余分别为93.3%（14/15）、89.6%（60/67）和90.2%（74/82）。结论：超声造影在肿瘤残留判断中有较高的敏感性及特异性，有助于脑胶质瘤手术切除。

Objective: To investigate the clinical value of contrast-enhanced ultrasound in the diagnosis of tumor residue in brain gliomas. Methods: From January 2012 to April 2016, 101 cases brain glioma treated in our hospital underwent conventional ultrasound and contrast-enhanced ultrasound before and after resection of tumor. Results: Compared with low grade gliomas, the rise time (RT), time to peak (TTP), maximum intensity (IMAX) and tumor edema ratio had increased inhigh grade gliomas(P < 0.05). In the low grade gliomas, the diagnosis of tumor residual sensitivity, specificity and accuracy rate in the intraoperative conventional ultrasound were 70.0%(14/20), 73.9%(68/92) and 73.2%(82/112), respectively. While in the contrast enhanced ultrasound, 90.0%(18/20), 83.7%(77/92) and 84.8%(95/112), respectively. In the high grade gliomas, the diagnosis of tumor residual sensitivity, specificity and accuracy rate in the intraoperative conventional ultrasound were 66.7%(10/15), 74.6%(50/67) and 73.2%(60/82), respectively. While in the contrast enhanced ultrasound, 93.3%(14/15)、89.6%(60/67) and 90.2%(74/82), respectively. Conclusion: The clinical value of contrast-enhanced ultrasound in the diagnosis of residual tumor is high, which is helpful for surgical resection of glioma.

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