比较常规超声检查和超声造影（CEUS）对肝脏局灶性病变（FLL）的检出能力。

回顾性分析2006年8月至2011年1月在中山大学附属第三医院超声科先后行常规超声检查和CEUS的54例FLL患者临床资料。其中男47例，女7例；年龄（52±15）岁。所有患者均签署知情同意书，符合医学伦理学规定。先用B超模式和彩色多普勒超声对肝脏作常规超声检查，然后采用对比脉冲序列特定成像技术，应用造影剂六氟化硫微泡（声诺维）进行CEUS。最终诊断根据增强计算机体层摄影术（CT）或磁共振成像（MRI）、穿刺或手术病理诊断结果及随访结果综合判断。两种检查方法对病灶检出情况比较采用χ²检验。

54例中33%（18/54）的患者常规超声检查未见病灶或显示不清，CEUS显示病灶清晰且能作出定性诊断。54例患者中最终确诊178个病灶，其中肝细胞肝癌（肝癌）病灶123个、胆管细胞肝癌病灶7个、转移性肝癌病灶30个、肝血管瘤病灶18个；常规超声检查分别定性诊断46、2、7、7个病灶，CEUS分别为114、5、23、16个病灶，两种方法对肝癌、转移性肝癌及肝血管瘤定性诊断的差异有统计学意义（χ²=112.083,17.076, 9.753；P<0.05）。常规超声病灶检出率为34.8%（62/178），CEUS检出率为88.8%（158/178），差异有统计学意义（χ²=109.656，P<0.05）。75个直径<10 mm的病灶中，常规超声检查检出5个，而CEUS检出66个，差异有统计学意义（χ²=99.510，P<0.05）；85个直径10~30 mm的病灶中，常规超声检查检出39个，而CEUS检出74个，差异有统计学意义（χ²=32.332，P<0.05）；直径>30 mm的18个病灶常规超声检查和CEUS均可检出。

CEUS检出FLL的能力明显优于常规超声检查，尤其能显著提高肝内亚厘米级微小病灶的检出率，具有较高的临床应用价值。

To compare the detective capability of focal liver lesion(FLL) between the conventional ultrasound and contrast-enhanced ultrasound(CEUS).

Clinical data of 54 patients with FLL, who received conventional ultrasound and CEUS examination in Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University from August 2006 to January 2011, were analyzed retrospectively. There were 47 males and 7 females with the mean age of(52±15) years old. The informed contents of all patients were obtained and the ethical committee approval was recieved. Conventional ultrasound examination(including B-mode and color Doppler ultrasound) was performed firstly, then CEUS examination was used with contrast pulse sequence imaging technique and contrast agent(SonoVue). The confirmation was made according to the results of enhanced computed tomography(CT) or magnetic resonance imaging(MRI), puncture or surgical pathological diagnosis, and follow-up results. The results of two methods were compared by Chi-square test.

Of 54 cases, 33%(18/54) FLL could not be detected or clearly displayed by conventional ultrasound, while could be clearly displayed and diagnosed by CEUS. A total of 178 lesions were finally confirmed in 54 patients, including 123 hepatocellular cancer (HCC) lesions, 7 intrahepatic cholangiocarcinoma(ICC) lesions, 30 metastatic hepatic carcinoma lesions, 18 hepatic hemangioma lesions. In the above 4 kinds of lesions, 46, 2, 7, 7 lesions were detected by conventional ultrasound respectively and 114, 5, 23, 16 by CEUS respectively. There were significant differences between two methods in the diagnosis of HCC, metastatic hepatic carcinoma and hepatic hemangioma (χ²=112.083, 17.076, 9.753; P<0.05) . The detective rate of conventional ultrasound and CEUS was 34.8%(62/178) and 88.8%(158/178) respectively. There was significant difference between two methods (χ²=109.656, P<0.05) . Five out of 75 lesions with the diameter smaller than 10 mm, 5 lesions were detected by conventional ultrasound, while 66 lesions were detected by CEUS. There was significant difference betwwen two methods (χ²=99.510, P<0.05) . In 85 lesions with the diameter from 10 to 30 mm, 39 lesions were detected by conventional ultrasound, while 74 lesions were detected by CEUS. There was significant difference betwwen two methods (χ²=32.332, P<0.05) . Eighteen lesions with diameter larger than 30 mm could be detected by conventional ultrasound and CEUS.

The detective capability of CEUS for FLL is superior to the conventional ultrasound. CEUS can especially improve the detective rate of small lesions with subcentimeter in the liver and has better clinical application value.