超声造影定量参数在局灶性结节样增生与肝细胞癌鉴别诊断中的价值  

The Value of Quantitative Parameters of Contrast-enhanced Ultrasound in the Differential Diagnosis of Focal Nodular Hyperplasia and Hepatocellular Carcinoma

作　　者：姜琴[1] 廖锦堂[1] 刘艳[1] 

机构地区：[1]中南大学湘雅医院超声影像科,长沙市410008

出　　处：《中国超声医学杂志》2011年第9期831-834,共4页Chinese Journal of Ultrasound in Medicine

基　　金：湖南省自然科学基金(No.09JJ5020)

摘　　要：目的探讨超声造影定量参数在鉴别局灶性结节样增生(FNH)与造影表现不典型的肝细胞癌(HCC)中的价值。方法利用QLab软件绘制17例FNH与21例造影表现不典型(门脉相呈高增强或等增强)的HCC的超声造影时间-强度曲线,得出FNH与HCC的血流灌注参数(造影剂到达时间、达峰时间、峰值强度),并计算出增强时间与增强斜率,将这些参数进行对比分析。结果 (1)造影剂到达时间FNH组为(10.53±3.44)s,HCC组为(13.11±3.96)s;(2)达峰时间FNH组为(17.59±6.37)s,HCC组为(24.54±9.18)s;(3)增强时间FNH组为(7.06±3.30)s,HCC组为(11.32±7.03)s。FNH组与HCC组的造影剂到达时间、达峰时间、增强时间比较差异有统计学意义(P<0.05)。(4)峰值强度FNH组为(56.97±40.60)dB,HCC组为(68.80±38.32)dB;(5)增强斜率FNH组为(9.08±5.35)dB/s,HCC组为(7.11±4.12)dB/s。FNH组与HCC组的峰值强度及增强斜率比较差异无统计学意义(P>0.05)。结论 FNH与门脉相呈等或高增强的HCC超声造影定量参数造影剂到达时间、达峰时间及增强时间存在差异,FNH的造影剂到达时间及达峰时间早于HCC,增强时间较HCC短。超声造影定量参数有助于FNH与造影表现不典型HCC的鉴别诊断。Objective To evaluate the value of quantitative parameters of contrast-enhanced ultrasound （CEUS） in the differential diagnosis of focal nodular hyperplasia （FNH） and hepatocellular carcinoma （HCC）. Methods 17 FNH patients （FNH group） and 21 HCC patients （HCC group） which were equally or highly enhanced in portal venous phase were analyzed. The arrival time （AT）, time to peak （TTP） and peak intensity （PI） of the liver lesions were measured by time- intensity curve software. The enhancement time （ET） and ascending slope （AS） were calculated with these parameters. The parameters in FNH group were statistically compared with that in HCC group. Results（l） AT： FNH group： 10. 53±3.44 s, HCC group： 13.11±3.96 s; （2） TTP： FNH group： 17.59 ±6.37 s, HCC group： 24.54±9.18 s; （3） ET： FNH group： 7.06±3.30 s, HCC group： 11.32±7.03 s. All of the above parameters showed statistical significance between FNH group and HCC group （P〈0.05）. （4） PI： FNH group： 56.97±40.60 dB, HCC group： 68.80±38.32 dB; （5） AS： FNH group： 9.08± 5.35 dB/s, HCC group： 7. 11 ±4.12 dB/s. No difference was observed （P〉 0.05）. Conclusions AT and TTP were earlier in FNH group than that in HCC group, and ET was shorter in FNH group than that in HCC group. The quantitative analysis of CEUS can be benefit for the differential diagnosis of FNH and HCC which were equally or highly enhanced in portal venous phase.

关 键 词：超声造影 肝细胞癌 局灶性结节样增生 定量参数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]