原发性肝癌患者剪切波速度和超声造影定量参数与病理微血管密度关系研究  

Correlation Between Shear Wave Velocity, Quantitative Parameters of Contrast- enhanced Ultrasound and Micro Vessel Density in Patients With Primary Liver Cancer

作　　者：薛薇[1] 赵玉珍[1] 何其佳[1] 阳练 笪冀平[2] 蒋惠君[2] 

机构地区：[1]中日友好医院超声科,北京市100029 [2]中日友好医院病理科,北京市100029

出　　处：《中国全科医学》2015年第27期3376-3380,共5页Chinese General Practice

基　　金：首都卫生发展科研专项(首发2011-4012-01)

摘　　要：目的探讨原发性肝癌患者病灶剪切波速度(SWV)、超声造影(CEUS)定量参数与病理微血管密度(MVD)的相关性。方法 2012年7月—2014年6月于中日友好医院行超声检查检出肝局灶性病变的187例患者中,选取经手术、病理证实的原发性肝癌患者39例(肝细胞肝癌35例,混合型肝癌3例,胆管细胞癌1例)为研究对象。术前采用声触诊组织量化技术(VTQ)获取病灶及病灶周围背景肝组织SWV,通过CEUS检查获取病灶及病灶周围背景肝组织CEUS定量参数(始增时间、始增强度、达峰时间、峰值强度、120 s回声强度、峰值加速时间、强度增量、增强速率和消退速率),并测定病灶及病灶周围背景肝组织MVD。结果病灶与病灶周围背景肝组织SWV分别为(2.84±0.68)m/s和(1.67±0.47)m/s,差异有统计学意义(t'=8.818,P<0.001)。病灶始增时间、达峰时间、峰值加速时间以及120 s回声强度小于病灶周围背景肝组织(P<0.05),病灶增强速率大于病灶周围背景肝组织(P<0.05)。病灶始增强度、峰值强度、强度增量、消退速率与周围背景肝组织比较,差异无统计学意义(P>0.05)。病灶与病灶周围背景肝组织MVD分别为(54.75±22.31)和(12.52±8.41),差异有统计学意义(t'=11.060,P<0.001)。病灶SWV与MVD无线性相关关系(r=0.143,P=0.385)。病灶达峰时间、峰值加速时间与病灶MVD呈负相关(r=-0.632、-0.781,P<0.05);病灶增强速率与MVD呈正相关(r=0.696,P<0.05);病灶始增时间、始增强度、峰值强度、120 s回声强度、强度增量、消退速率与MVD无线性相关关系(P>0.05)。结论 VTQ通过测定SWV可以定量评估原发性肝癌患者病灶组织硬度,但间接反映其血供的假设仍有待于更为深入的研究;原发性肝癌患者CEUS参数中的达峰时间、峰值加速时间、增强速率与MVD具有相关性,其在评估原发性肝癌患者血供方面具有良好的应用前景。Objective To investigate the correlation between shear wave velocity（ SWV）,quantitative parameters of contrast-enhanced ultrasound and micro vessel density（MVD）of the nidus of primary liver cancer（PLC）. Methods Among 187 patients who were diagnosed as focal liver lesion by ultrasonography in the Department of Ultrasound of China - Japan Friendship Hospital from July 2012 to June 2014,39 patients（35 patients with hepatocellular carcinoma,3 patients with mixed type liver cancer and 1 patient with cholangiocarcinoma）who were diagnosed as PLC by surgery and pathology were enrolled in the study. Before surgery,the virtual touch tissue quantification（ VTQ）method was used to detect the SWV of nidus and background liver tissues. The CEUS method was employed to acquire quantitative parameters of contrast-enhanced ultrasound （ initial time increase,initial strength increase,time to peak,peak intensity,120 s echo intensity,peak accelerating time,strengthnbsp;increase,increase velocity and decrease velocity ） of nidus and background liver tissues. The MVD values of nidus and background liver tissues were determined. Results The SWV values of nidus and backgroud liver tissues were （ 2. 84 ± 0. 68 ） m/s and（1. 67 ±0. 47）m/s respectively,with significant difference between them（t＇=8. 818,P〈0. 001）. Nidus was lower （P〈0. 05）in initial time increase,time to peak,peak accelerating time and 120 s echo intensity and higher（P〈0. 05）in increase velocity than background liver tissues. Nidus and background liver tissues were not significantly different（P〉0. 05）in initial intensity increase,peak intensity,intensity increase and decrease velocity. The MVD values of nidus and background liver tissues were（54. 75 ±22. 31）and（12. 52 ±8. 41）respectively,with significant difference between them（t＇=11. 060,P〈0. 001）. No linear correlation was found between SWV and MVD of nudis（r=0. 143,P=0. 385）. For nidus,time to peak and peak accelerating time were negatively co

关 键 词：肝肿瘤 声触诊组织量化技术 剪切波速度 超声检查 微血管 

分 类 号：R735.7[医药卫生—肿瘤]