RESUMEN
Objective To compare the efficacy of contrast-enhanced ultrasound (CEUS) and enhanced CT (CECT) in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.Methods The clinical data of 68 cases of space-occupying lesions of gallbladder confirmed by surgery and biopsy were retrospectively analyzed.The diagnostic accuracy,sensitivity and specificity of CEUS and CECT were analyzed and compared.Results In a total of 68 cases of space-occupying lesions of gallbladder,31 cases were benign lesions and 37 were malignant lesions (gallbladder cancer).For the benign lesions cases,CEUS and CECT were mainly hyper-enhanced in the early stage of enhancement,which were 90.3％ and 83.9％,respectively.In the late stage of enhancement,they were mostly low-enhanced,which were 93.5％ and 87.1％,respectively.For the gallbladder cancer cases,CEUS and CECT were predominantly hyper-enhanced in the early stage of enhancement,which were 94.6％ and 89.2％,respectively,and were all low-enhanced in the late stage of enhancement.In the differential diagnosis for benign and malignant space-occupying gallbladder lesions by CEUS,the differences in peak time,extinction time,peak intensity and average transit time were statistically significant (all P＜0.01).The inhomogeneous enhancement rates were 41.9％ and 48.4％ respectively for CEUS and CECT in the benign lesions cases,and 94.6％ and 91.9％ in the gallbladder cancer cases.Besides,the incomplete gallbladder wall rates are 89.2％ and 91.9％ in the gallbladder cancer cases.However,these differences were all not statistically significant (all P＞0.05).In the diagnosis of benign and malignant lesions cases,the diagnostic accuracy of CEUS and CECT were 92.6％ and 89.7％,the sensitivity was 93.5％ and 90.3％,and the specificity was 89.2％ and 83.8％,respectively,but the differences were not statistically significant (all P＞0.05).Conclusion CEUS and CECT have comparable efficacy in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.CEUS has advantages over CECT and is worthy of extensive clinical application and promotion.
RESUMEN
Promotion of outstanding people to head nurses is key to hospital nursing management.In view of the current shortcomings in the analysis of appraisal data and the interpretation of appraisal results,the analysis of means(ANOM)method is introduced to the process of hospital human resource management.The proposed method aims to solve the problem when the score differences between interviewers are great and the score differences between candidates are small.An example for head nurses' promotion appraisal in a hospital is offered to demonstrate that statistical tools can provide the decision support for hospital personnel selection.Finally,the application differences between ANOM and analysis of variance(ANOVA) in human resources appraisal are compared.