实时超声造影定量分析肝细胞癌分化程度的应用初探  

Tumor Cellular Differentiation of Hepatocellular Carcinoma: Assessmentusing Quantification of Real Time Contrast-enhanced Ultrasound

作　　者：王洁 林尤恩 云文耀 邱丹婷 李薇[2] 陈立达[2] 

机构地区：[1]增城新塘医院超声科 [2]中山大学附属第一医院超声科,广东广州511340

出　　处：《中山大学学报（医学科学版）》2015年第5期758-762,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(30901384);广东省医学科研基金(B2012094);揭阳市科技计划基金(0201)

摘　　要：【目的】探讨实时超声造影(CEUS)定量分析不同分化程度肝细胞癌(HCC)的价值。【方法】回顾性分析173例病理证实为HCC的CEUS图像,采用Sono Liver定量软件脱机分析以下定量参数:造影剂到达时间(AT)、达峰时间(TTP)、平均渡越时间(m TT)和峰值强度(IMAX)。参照Edmonson病理分级,病例分为高、中、低分化HCC共三组,病例数分别为21、84、68,并分析各组间定量参数的差异。【结果】肿瘤大小与分化程度无相关性(P=0.372)。高、中、低分化HCC的TTP分别为(25.3±4.8)s、(19.5±6.4)s、(15.1±4.3)s,m TT分别为(107.4±32.7)s、(74.4±29.8)s、(49.7±20.9)s,逐渐降低,差异具有统计学意义(P=0.008-0.036)。中分化组IMAX(217.8±50.2)a.u较高分化组(144.3±46.4)a.u和低分化组高(153.7±48.6)a.u,差异具有统计学意义(P=0.001-0.013)。AT在各组件的比较无显著统计学差异(P=0.283)。【结论】CEUS定量分析能客观地显示不同分化HCC间的微循环血流灌注差异。【Objective】 To investigate the usefulness of quantitative contrast-enhanced ultrasound（CEUS） in the tumor cellular differentiation of hepatocellular carcinoma（HCC）. 【Methods】 One hundred and seventy-three HCCs with CEUS were included in this retrospective study, which were all proven histologically. Quantitative parameters including arrival time（AT）, time to peak（TTP）,mean transit time（m TT） and maximum intensity（IMAX） were analyzed using offline Sono Liver software. According to Edmonson classification, HCCs were grouped as well differentiated（w-HCC）, moderately differentiated（m-HCC） and poorly differentiated（pHCC）, including 21, 84, and 68 cases, respectively. Differences of quantitative parameters between groups were analyzed. 【Results】No correlation was observed between the tumor size and the tumor differential degree（P = 0.372）. The TTPs were（25.3 ± 4.8）s,（19.5± 6.4） s and（15.1 ± 4.3） s, for w-HCC, m-HCC, and p-HCC, respectively. The m TTs were（107.4 ± 32.7）s,（74.4 ± 29.8） s,and（49.7 ± 20.9） s for w-HCC, m-HCC, and p-HCC, respectively. Both TTP and m TT decreased significantly with the decreasing degree of histological differentiation（P = 0.008-0.036）. The IMAX of m-HCC（217.8 ± 50.2） a.u was higher than w-HCC（144.3 ±46.4） a.u and p-HCC（153.7 ± 48.6） a.u significantly（P = 0.001-0.013）. But the AT had no significant statistical difference among different groups（P = 0.283）. 【Conclusion】 Quantitative analysis of CEUS was able to demonstrate the difference of the microciculation in different degree of histological differentiation of HCCs.

关 键 词：肝细胞癌 病理分化 超声造影 定量 

分 类 号：R730.4[医药卫生—肿瘤] R735.7[医药卫生—临床医学]