Application Value Of Conventional Ultrasound And Contrast-Enhanced Ultrasonography In The Diagnosis Of Benign And Malignant Omental Lesions

Objective:To establish a prediction model of the nature of the greater omentum lesions and to explore the application value of conventional ultrasound and contrast-enhanced ultrasound in the greater omentum lesions.Methods:114 patients who met the inclusion criteria for ultrasound-guided needle biopsy of omentum lesions in our hospital from September 2020 to December 2022 were selected as study analysis objects.The clinical data,conventional ultrasound images and contrast-enhanced ultrasound dynamics of all cases were retrospectively analyzed,and pathological diagnosis was taken as the gold standard,univariate analysis and multivariate dichotomous logistic regression analysis were carried out,a prediction model was established,and evaluate the diagnostic value of the prediction model.Results:Among 114 cases of greater omentum lesions that underwent ultrasound-guided needle biopsy and were clearly diagnosed pathologically,89 cases were malignant and 25 cases were benign.There were statistically significant differences in age,sex,greater omentum thickness and CDFI blood flow grade between benign and malignant greater omentum lesions(P>0.05).But there was no significant significance in whether thickened omentum was accompanied by nodules between the two groups(P>0.05).By analyzing the contrast ultrasound perfusion patterns of the subjects,it was found that the malignant lesions group was mainly high enhancement(73.0%),and the benign lesions group was mainly low enhancement(76.0%),and the difference in enhancement uniformity between benign and malignant lesion groups was not statistically significant(P>0.05).The BI of benign and malignant lesions were 10.58 ± 8.29 d B and 14.88 ±9.13 d B respectively,the difference was statistically significant(P<0.05).The PI of benign and malignant lesions were 29.10±8.25 d B and 47.29±8.66 d B respectively,the difference was statistically significant(P<0.05).The AS of benign and malignant lesions were 0.87±0.37 d B/s and 1.45±0.79 d B/s respectively,the difference was statistically significant(P<0.05).The A of benign and malignant lesions were21.57±8.53 d B and 32.42±8.91 d B respectively,the difference was statistically significant(P<0.05).There was no significant difference in AT and TTP between the two groups(P>0.05).Apply Multivariate dichotomous logistic regression analysis to establish the prediction model: Y=-14.457+0.059 * age+2.025 * with nodules+0.181 * PI+3.116 * AS.Where Y is the predictive value of the nature of the greater omentum lesions.The best cutoff value of Y is 0.660(that is,when Y>0.660,it is judged as malignant),the area under the curve is 0.924,the prediction sensitivity is 88.8%,the specificity is 84.0%,and the Youden’s index is 0.720.The overall prediction accuracy of the model is 88.6%,and the prediction result of the model is good.Conclusions:1.In univariate analysis,the age,sex,greater omentum thickness,and CDFI blood flow grade of patients were all related to greater omentum malignant lesions.2.Contrast-enhanced ultrasound can reflect the perfusion of blood flow in the greater omentum,and the perfusion mode of contrast-enhanced ultrasound varies between benign and malignant omentum Lesions.3.In the quantitative analysis of contrast-enhanced ultrasound parameters,BI,PI,A and AS have significant differences between benign and malignant omental lesions,which indicates that contrast-enhanced ultrasound quantitative analysis has very important value in the differentiation of the two.4.Multivariate analysis was used to establish a prediction model for the nature of greater omentum lesions,with high prediction accuracy.