Study On The Diagnosis Of Small Space-occupying Lesions In The Background Of Liver Cirrhosis By Contrast-enhanced Ultrasonography Combined With Tongue Diagnosis

Objective:To analyze the characteristics of benign and malignant liver lesions by real-time contrast-enhanced ultrasound(CEUS)combined with tongue diagnosis of traditional Chinese medicine,and to explore the diagnostic value of this feature for benign and malignant lesions,so as to guide the early diagnosis of liver cirrhosis regenerative nodules and primary small hepatocellular carcinoma.Methods:Select September 2018 to September 2020,see a doctor in our hospital during the period of 67 patients with cirrhosis of the liver and the small space-occupying lesions in the liver as the research object,respectively in patients with the line of tongue diagnosis(including tongue coating on the tongue,tongue coating fall off cytology),ultrasonic imaging examination,and then double-blind tongue diagnosis,tongue diagnosis,ultrasonic imaging and joint tongue diagnosis of 3 kinds of methods to analyze under the background of liver cirrhosis small placeholder of benign and malignant lesions.All lesions were compared with the "gold standard" results of biopsy or surgical pathological diagnosis.The sensitivity,specificity and accuracy of the three methods were analyzed to explore the value of ultrasonography combined with tongue diagnosis in differentiating regenerated nodules of cirrhosis from small hepatocellular carcinoma.Results:Among 67 cases of hepatic space occupying lesions,41 cases were primary small hepatocellular carcinoma and 26 cases were regenerative nodules.Among 67 cases of space occupying lesions,38 cases of primary small hepatocellular carcinoma and 29 cases of regenerative nodules were predicted by pathological tongue diagnosis.Among 67 cases of space occupying lesions,43 cases of primary small hepatocellular carcinoma and 24 cases of regenerative small nodules were predicted by CEUS combined with pathological tongue diagnosis.Among 67 cases of hepatic space occupying lesions,45 cases were primary small hepatocellular carcinoma and 22 cases were regenerative nodules.The sensitivity,specificity and accuracy of CEUS in the diagnosis of SHCC were 84.4%(38/45),86.3%(19/22)and 85.0%(57/67),respectively.The sensitivity,specificity and accuracy of pathological tongue examination in the diagnosis of primary liver cancer were 71.1%(32/45),72.7%(16/22)and 71.6%(48/67),respectively.The sensitivity,specificity and accuracy of CEUS combined with pathological tongue examination in the diagnosis of PHC were 91.1%(41/55),90.9%(20/22)and 91%(61/67),respectively.The correlation between CEUS,pathological tongue examination and pathological diagnosis was statistically significant(P<0.05).Conclusion:CEUS combined with pathological tongue diagnosis can significantly improve the accuracy of diagnosis and differential diagnosis of benign and malignant liver nodules,which has important value in guiding the early diagnosis of liver cancer and making effective and standardized treatment plan.