肝细胞肝癌超声造影与微血管密度的相关性研究  

Correlative study of contrast-enhanced ultrasonography and microvessei density in hepatocellular carcinoma

作　　者：白敏[1] 杜联芳[1] 张雪梅[2] 李凡[1] 伍瑛[1] 张会萍[1] 

机构地区：[1]上海交通大学附属第一人民医院超声科,200080 [2]上海交通大学附属第一人民医院病理科,200080

出　　处：《中华超声影像学杂志》2010年第3期223-226,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨肝细胞肝癌（HCC）的超声造影定量参数与其组织中微血管密度（MVD）的相关性，探讨超声造影无创评价HCC血管生成的价值。方法应用Sequoia512超声诊断仪及造影剂SonoVue对28个HCC病灶行超声造影检查，脱机应用新型超声造影定量分析软件（SW—UCS）获得肿瘤及同深度癌旁肝实质的感兴趣区的时间强度曲线（TIC）和灌注定量参数。术后病理切片行CD34免疫组织化学染色并测得MVD。分析比较超声造影定量参数与MVD的相关性。结果HCC与肝实质TIC曲线可以直观反映HCC相对于肝实质“快进快出”的典型增强表现。两者曲线上升速率（a3）、达峰时间（TTP）、峰值强度（PI）、强度增量（ISI）、加速时间（ACT）差异有统计学意义（P〈0．05）。HCC的MVD（49．36±12．57）明显高于癌旁肝实质（32．46±11．78），两者差异有统计学意义（P=0．000）。HCC的PI、ISi、曲线下面积（AUc）与MVD呈正相关，峰值减半斜率（a2）与MVD呈负相关（P〈0．05）。结论HCC的超声造影定量参数与MVD有一定的相关性，能无创地评估活体内HCC的血管生成。Objective To study the correlation between quantitative parameters of contrast-enhanced ultrasonography （CEUS） and microvessel density （MVD） in hepatocellular carcinoma （ HCC）, and to investigate the value of CEUS in noninvasively assessing HCC angiogenesis. Methods The patients with 28 HCCs confirmed by pathology were examined by CEUS. A new type quantification software SW-UCS was used to delineate time-intensity curve（TIC） and to obtain quantitative parameters of HCC and hepatic parenchyma in region of interest. The quantitative parameters were compared with MVD, which was counted by immunohistochemistry method using CD34 antibody, and the correlation between them was studied. Results The TICs of HCC showed typical contrast enhancement pattern of ＂fast-in and fast out＂ comparing with normal hepatic parenchyma. There were significant differences between HCC and hepatic parenchyma in slope of rise time（a3）,time to initial peak（TTP）, peak intensity（H）, increased signal intensity（ISI） and acceleration time（ACT） （P 〈0.05）. MVD in HCC （49.36±12.57） was higher than that in hepatic parenchyma （32.46 ± 11.78, P 0. 000）. For HCC, the PI, ISI and area under curve were positively correlated with MVD,while the slope of decrease to half of peak（a2） was negatively correlated with MVD （ P 〈0.05）. Conclusions The quantitative parameters of CEUS in HCC were corrdated with MVD,CEUS can evaluate the angiogenesis of HCC in vivo noninvasively.

关 键 词：超声检查 微气泡 癌 肝细胞 新生血管化 病理性 

分 类 号：R735.7[医药卫生—肿瘤]