Objective To evaluate the application value of contrast-enhanced ultrasound ( CEUS) in the diagnosis of renal occupied lesions systematically.Methods The related literatures which used CEUS in the diagnosis of renal occu-pied lesions were searched from Pubmed, Embase, Cochrane Library, CBM and CNKI database.The heterogeneity test was conducted on these literatures by using Stata 12.0 and Meta-disc software.The weighted sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio and negative likelihood ratio were calculated as well as the summary receiver operating characteristic ( SROC) curve.Results Fourteen literatures were included, the weighted sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio and negative likelihood ratio were 0.957, 0.748, 66.277, 3.797 and 0.057, respec-tively;and the SROC curve was 0.96.Conclusion Using CEUS has a low missed diagnosis rate, an relative high misdi-agnosis rate and small range of summary sensitivity in the differential diagnosis of renal occupied lesions.

The aim of the present study was to assess the value of real-time elastography (RTE) quantitative parameters, namely the liver fibrosis (LF) index and the ratio of blue area (% AREA), in evaluating the stage of liver fibrosis. RTE quantitative analysis software was used to examine 120 patients with chronic hepatitis in order to obtain the values for 12 quantitative parameters from the elastic images. The diagnostic performance of two such parameters, the LF index and % AREA, were assessed with a receiver operating characteristic (ROC) curve to determine the optimal diagnostic cut-off values for liver cirrhosis and fibrosis. A good correlation was observed between the LF index and % AREA with the fibrosis stage. The areas under the ROC curve for the LF index were 0.985 for the diagnosis of liver cirrhosis and 0.790 for liver fibrosis. With regard to % AREA, the areas under the ROC curve for the diagnosis of liver cirrhosis and fibrosis were 0.963 and 0.770, respectively. An LF index of >3.25 and a % AREA of >28.83 for the diagnosis of cirrhosis stage resulted in sensitivity values of 100 and 100%, specificity values of 88.9 and 85.9% and accuracy values of 90.8 and 88.3%, respectively. The LF index and % AREA parameters exhibited higher reliability in the diagnosis of liver cirrhosis compared with the diagnosis of the liver fibrosis stage. However, the two parameters possessed a similar efficacy in the diagnosis of liver cirrhosis and the stage of liver fibrosis. Therefore, the quantitative RTE parameters of the LF index and % AREA may be clinically applicable as reliable indices for the early diagnosis of liver cirrhosis, without the requirement of an invasive procedure.

肝纤维化(LF)是肝硬化的早期改变,如果在此时消除病因,积极治疗,纤维化可以逐步缓解.我们应用无创的超声弹性成像技术评估LF程度,并探讨LF指数诊断早期肝硬化期及LF期的最佳临界值.一、材料与方法1.研究对象:选取2010年6月至2013年3月在我院就诊的慢性肝炎患者123例,其中男89例,女34例,平均年龄(43.7±9.2)岁,其中乙肝114例,丙肝9例.病理获取途径为肝穿刺活检.排除可能导致肝实质病变的慢性疾病及可能影响肝脏弹性的其他病变.肝穿刺活检组织的LF分级标准按Metavir分级:S0,无LF;S1,汇管区有纤维化但无分隔;S2,汇管区有纤维化伴少量分隔;S3,有大量分隔但无肝硬化;S4,早期肝硬化。