目的 探讨超声造影在诊断脂肪肝合并HBsAg阳性背景下局灶性病变的应用价值.方法 回顾性分析脂肪肝合并HBsAg阳性背景下的55例患者58个局灶性病变的超声造影灌注模式,结合病理诊断结果,探讨超声造影对脂肪肝合并HBsAg阳性背景下肝脏良恶性病变的诊断价值.结果 58个病变中,血管瘤29个,脂肪缺失10个,2个重度不典型增生结节,孤立性坏死结节2个,2个大细胞神经内分泌癌,3个炎性病变,10个病变为肝细胞肝癌.常规超声与超声造影诊断脂肪肝肝合并HBsAg阳性背景下局灶性病变准确性41.4%、72.4%,差异具有有统计学意义(P<005).结论 超声造影检查可以实时动态观察脂肪肝合并HBsAg阳性背景下局灶性病变的血流灌注方式,可为鉴别诊断提供重要信息,具有较好的临床应用价值.%Objective To evaluate the value of contrast-enhanced ultrasonography in the diagnosis of fatty liver patients with HBsAg positive background. Methods 58 focal lesions of 55 fatty liver cases with HBsAg positive background were analyzed retrospectively. The diagnosis of benign and malignant liver lesions was established by contrast-enhanced ultrasonography. Results Among the 58 lesions, 29 were hemangiomas, 10 were deficient in fat, 2 were atypical hyperplastic nodules, 2 were isolated necrosis, 2 were large cell neuroendocrine carcinoma, 3 were inflammatory lesions, 10 were hepatocellular carcinoma. The accuracy of conventional ultrasound and ultrasonography in the diagnosis of fatty liver and liver with HBsAg positive background was 41.4% and 72.4%, with statistically significant difference (P<005). Conclusion Contrast-enhanced ultrasonography can observe the blood perfusion of fatty liver with HBsAg positive background, which can provide important information for differential diagnosis and have good clinical application value.
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