超声造影在肝硬化结节与小肝癌的诊断与鉴别诊断中的价值  

Value of contrast-enhanced ultrasound in the diagnosis and differential diagnosis of hepatocirrhosic nodules and sHCC

作　　者：孟繁坤[1] 张嫄[1] 穆晓洁[1] 张海英[1] 徐策[1] 丁蕾[1] 郑颖[1] 

机构地区：[1]首都医科大学附属北京佑安医院超声科

出　　处：《临床超声医学杂志》2009年第3期155-158,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声造影在肝硬化结节与小肝癌的诊断与鉴别诊断中的价值。方法96例临床诊断为肝硬化患者经常规超声检查发现单个或多个小结节进行了超声造影检查，并分析造影后声像图特点。结果68例（161枚）肝硬化结节大小为0．6～1．8cm，28例（31枚）小肝癌大小为0．8～2．0cm。肝硬化结节造影后表现为：①133枚（82．6％）动脉相无增强、门脉相和延迟相呈等增强；②19枚（11．8％）动脉相无增强，门脉相低增强，延迟相等增强；③3枚（1．9％）动脉相、门脉相及延迟相均呈无增强；④4枚（2．5％）动脉相晚期部分增强，门脉相低增强，延迟相低或等增强；⑤2枚（1．2％）动脉相、门脉相高增强，延迟相等增强。28例小肝癌造影后动脉相高增强，门脉相呈等或低增强，延迟相呈低增强。结论超声造影检查可作为肝硬化结节重要随访手段，能早期诊断小肝癌，在肝硬化结节与小肝癌的诊断与鉴别诊断中具有重要价值。Objective To explore the value of contrast - enhanced ultrasound in the diagnosis and differential diagnosis of hepatocirrhosis nodules and small hepatcellular carcinoma （sHCC）. Methods Single or multiple nodules were found in 96 patients with hepatocin＇hosis by altrasonography, then examined by contrast- enhanced ultrasound, and the results was analyzed. Results The size of the 161 nodules in the 68 cases of hepatocirrhosic was 0.6 - 1.8 cm, and the size of the 31 nodules in the 28 cases of sHCC was 0.8- 2.0 cm. The appearance of hepatocirrhosic nodules after contrast - enhanced ultrasound were： ① the arterial phases was no enhancement, but the portal vein and lag phase were moderate enhancement; ②the arterial phases was no enhancement, but the portal vein phases was low enhancement, and the lag phases was moderate enhancement; ③the arterial, portal vein and lag phases were no enhancement; ④in advanced stage, the arterial phases was partial enhancement, the portal vein phases was low enhancement and the lag phases was low or moderate enhancement; ⑤the arterial phases and the portal vein phases was high enhancement, and the lag phases was low enhancement. In the 28 cases of sHCC, the appearance of arterial phases was high enhancement, the portal vein phases was moderate or low enhancement, and the lag phases was low enhancement. Conclusion The contrast - enhanced ultrasound can be used as an important method for follow- up visit in the diagnosis of hepatocirrhosic nodules, also can be used in the early diagnosis of sHCC. It has significant value in the diagnosis and differential diagnosis of hepatocirrhosis nodules and sHCC.

关 键 词：超声检查 造影剂 肝硬化 小肝癌 结节 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]