原发性肝癌超声造影特征及其与病理相关性的研究  

The contrast-enhanced ultrasound characteristics and its correlation with pathology in primary hepatic cancer

作　　者：司芩[1] 钱晓莉[1] 黄声稀[1] 吕校平[1] 仝威[1] 黄艳丽[1] 

机构地区：[1]解放军八一医院特诊科,南京210002

出　　处：《临床肿瘤学杂志》2011年第1期50-53,共4页Chinese Clinical Oncology

基　　金：全军"十一五"自然科学基金课题科技攻关资助项目(08G022);南京军区医学科技创新课题资助项目(09MA044)

摘　　要：目的评价超声造影(CEUS)对原发性肝癌(PHC)血供增强模式的显像特征,探讨PHC微血管构筑与病理组织学分型的关系。方法 278例329个PHC病灶行CEUS检查并分析其造影增强模式与病理特征的相关性。结果 PHC病灶造影模式:71.7%(236/329)为"快进快出,"13.4%(44/329)为"快进慢出,"7.3%(24/329)为"快进同出,"4.3%(14/329)为"慢进快出,"2.1%(7/329)为"慢进慢出,"1.2%(4/329)为"快进不出"。本组PHC病灶中,90.3%(297/329)为多血供病灶,见于肝细胞性肝癌(HCC);9.7%(32/329)为乏血供病灶,仅见于肝内胆管细胞癌(ICC)。PHC造影灌注填充模式与病灶大小有差异(P<0.05),灌注廓清模式与病灶大小无差异(P>0.05)。CEUS诊断PHC与病理对照,误诊9个病灶,诊断正确符合率为97.3%。结论 CEUS可判定PHC不同血供灌注特征并与病理组织学分型密切相关,对肝癌诊断与治疗具有重要临床价值。Objective To evaluate the value of contrast-enhanced ultrasound （CEUS） for blood perfusion of primary hepatic cancer （PHC） and investigate the correlation between microvascular architecture of PHC and pathological differentiation. Methods Two hundreds and seventy-eight patients with 329 PHC lesions were examined by CEUS and analyzed the contrast enhancemeu pattern and con＇elation with pathological features. Results CEUS patterns of PHC showed that 71.7% （236/329） ＂swift enhancement in the arterial phase and swift expurgation in the portal phase＂, 13.4% （44/329） ＂swift enhancement and slow expurgation＂, 7.3% （24/ 329 ） ＂swift enhancement and simultaneous expurgation＂, 4. 3% （ 14/329 ） ＂slow enhancement and swift expurgation＂, 2. 1% （ 7/ 329） ＂slow enhancement and expurgation＂ and 1.2% （4/329） ＂not fast forward＂. Ninety point three percentages（297/329） of PHC lesions were hypervascular liver cancer and 9. 7% （32/329） were hypovaseular. Hepatocellular carcinoma（HCC） were hypervascular leisons and intrahepatic cholangiocarcinoma （ICC） were hypovascular leisons. PHC size had significant differences on the contrast media puffusion pattern （P 〈0. 05） ,but not on the contrast media expurgation pattern. The accuracy of PHC by CEUS were 97.3% and compared to pathology, 9 leisons of PHC were misdiagnosed. Conclusion CEUS can show the different blood perfusion characteristics of PHC with closely related to pathological differentiation, which be valuable to diagnose liver cancer.

关 键 词：原发性肝癌 超声造影 微气泡 血供灌注 

分 类 号：R730.41[医药卫生—肿瘤] R735.7[医药卫生—临床医学]