超声造影在不同分化程度的原发性小肝癌诊断中的应用研究  

Study on the Application of Contrast-Enhanced Ultrasound in Diagnosis of Primary Small Hepatic Carcinoma with Different Degrees of Differentiation

作　　者：米波 

机构地区：[1]铜梁区人民医院超声科,重庆632560

出　　处：《中国医疗设备》2016年第8期47-50,共4页China Medical Devices

摘　　要：目的分析不同分化程度的原发性小肝癌(Primary Small Hepatic Carcinoma,PSHC)的超声造影特征,探讨超声造影在小肝癌诊断和分级中的临床应用价值。方法回顾性分析47例PSHC患者的超声造影及病理资料,比较不同分化程度的PSHC病灶的超声造影定量参数,分动脉相、门脉相和延迟相,比较不同分化程度的PSHC病灶超声增强强度的差异,并将超声造影诊断结果与病理诊断结果相比较,分析超声造影的诊断准确率。结果 47例患者的术后病理结果显示,高分化PSHC 22例、中分化PSHC 20例、低分化PSHC 5例。不同分化程度的PSHC病灶开始增强的时间及达峰时间相似(P>0.05),但造影剂消退时间差异显著(P<0.05)。在门脉相与延迟相,不同分化程度的PSHC病灶超声增强强度差异显著(P<0.05),且分化程度越低,低增强强度的比例越高。超声造影正确诊断PSHC 43例,诊断符合率为91.49%。结论不同分化程度的PSHC病灶的超声造影表现存在一定差异,超声造影能够为小肝癌的临床诊断和分级提供重要参考依据。Objective To analyze the characteristics of contrast-enhanced ultrasound（CEUS） of primary small hepatic carcinoma（PSHC） with different differentiated degrees so as to investigate the clinical effectiveness of application of CEUS in diagnosis and classification of this disease. Methods A retrospective analysis of CEUS data of 47 patients with PSHC confirmed by surgery and pathology was made. Quantitative parameter of CEUS for PSHC with different differentiated degrees was compared. Enhanced intensity among differentiated degree groups was compared in arterial phase, portal phase and delayed phase. Compared to pathological examinations, the diagnosis accordance rate of CEUS was analyzed. Results According to the postoperative pathological results of 47 patients, 22 cases were well differentiated, 20 cases were moderately differentiated and 5 cases were poorly differentiated. Both the arrival time and peak time were similar in PSHC with different degrees of differentiation, without statistically significant difference（P〉0.05）, but with statistically significant difference compared with the time to contrast washout（P〈0.05）. There was significant difference of enhanced intensity among differentiated degree groups in the portal phase and delayed phase（P〈0.05）. As the differentiated degree grew, the proportion of low enhanced intensity increased. 43 patients with PSHC were correctly diagnosed by CEUS, with a pathological diagnostic accordance rate of 91.49%. Conclusion Certain differences were seen between the CEUS characteristics of PSHC with different differentiated degrees. CEUS provided important references for clinical diagnosis and classification of PSHC.

关 键 词：超声造影 原发性小肝癌 分化程度 动脉相 门脉相 延迟相 

分 类 号：R445.1[医药卫生—影像医学与核医学]