多普勒超声与肝动脉DSA联合碘油CT检查诊断微小肝癌及肝良性结节  

Doppler ultrasonography and hepatic artery DSA combined with lipiodol CT in diagnosis of small hepatocellular carcinoma and benign nodule in cirrhosis patient

作　　者：苏赞瑞[1] 黄运福 林建军[1] 龙瑜[1] 陈璇[1] 林祖华[1] 李凤[1] 

机构地区：[1]广西医科大学第十附属医院钦州市第一人民医院介入科,广西钦州535000

出　　处：《中国介入影像与治疗学》2016年第10期619-622,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：广西壮族自治区钦州市科学研究与技术开发计划项目(20144004)

摘　　要：目的探讨多普勒超声与肝动脉DSA联合碘油CT检查对微小肝癌及肝良性结节的诊断价值。方法回顾性分析100例因临床高度怀疑原发性微小肝癌或肝癌术后复发性微小肝癌而接受多普勒超声及肝动脉DSA联合碘油CT检查的肝硬化患者影像资料,并与病理结果相对照。结果最终经病理诊断为微小肝癌80例共104个病灶,肝良性结节20例共27个病灶。多普勒超声检出微小肝癌病灶90个,检出率86.54%（90/104）;检出肝良性结节20个（均为肝硬化结节）,检出率74.07%（20/27）。肝动脉DSA联合碘油CT检出微小肝癌病灶96个,检出率92.31%（96/104）;检出肝良性病灶6个（其中无肝硬化结节）,检出率22.22%（6/27）。与肝动脉DSA联合碘油CT检查相比,多普勒超声对微小肝癌的检出率较低（χ~2=9.58,P〈0.05）,而对肝良性结节的检出率较高（χ~2=10.96,P〈0.05）。结论多普勒超声对肝硬化良性结节的检出更具优势,而DSA更有利于检出微小肝癌病灶。Objective To investigate the value of Doppler ultrasound and hepatic artery DSA combined with lipiodol CT in diagnosis of small hepatocellular carcinoma and benign nodule in liver.Methods Imaging data of 100 liver cirrhosis patients with highly suspected primary small liver cancer or liver cancer postoperative recurrence of small hepatocellular carcinoma were retrospectively analyzed and compared with pathological results.All the patients underwent Doppler ultrasound and hepatic artery DSA combined with lipiodol CT examinations.Results There were 80 patients with 104 lesions of small hepatocellular carcinoma and 20 patients with 27 lesions of benign nodule confirmed by pathology.Totally 90 cancerous lesions and 20 benign lesions were detected by Doppler ultrasound with the detection rate of 86.54%（90/104）and 74.07%（20/27）,respectively.All the ultrasound detected benign lesions were cirrhosis nodules.And a tatal of 96 cancerous lesions and 6 benign lesions were detected by hepatic artery DSA combined with lipiodol CT with the detection rate of92.31%（96/104）and 22.22%（6/27）,respectively.There was no cirrhosis nodules in hepatic artery DSA combined with lipiodol CT detected benign lesions.For small hepatocellular carcinoma,the detection rate of Doppler ultrasound was lower than that of hepatic artery DSA combined with lipiodol CT（χ~2=9.58,P0.05）.For benign nodule in liver,the detection rate of Doppler ultrasound was higher than that of hepatic artery DSA combined with lipiodol CT（χ~2=10.96,P0.05）.Conclusion Doppler ultrasound has more advantages in the detection of benign nodules in patients with liver cirrhosis,while DSA is more favorable for the detection of small hepatocellular carcinoma.

关 键 词：超声检查 多普勒 血管造影术 数字减影 体层摄影术 X线计算机 肝硬化 癌 肝细胞 结节 血管瘤 

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] R730.44[医药卫生—临床医学]