超声造影定量分析在鉴别肝硬化背景下肝内胆管细胞癌与原发性肝细胞癌中的作用  

Effect of ultrasound contrast quantitative analysis in distinguishing intrahepatic cholangiocarcinoma and primary hepatocellular carcinoma in hepatic cirrhosis

作　　者：杨思光 欧阳晓光 叶小楼 YANG Si-guang OUYANG Xiao-guang YE Xiaolou.(Department of Ultrasound, Guangdong Province Huizhou City Zhongda Huiya Hospital, Huizhou 516081, China)

机构地区：[1]广东省惠州市中大惠亚医院超声科,516081

出　　处：《中国实用医药》2017年第7期1-3,共3页China Practical Medicine

摘　　要：目的探讨超声造影定量分析在鉴别肝硬化背景下肝内胆管细胞癌(ICC)与原发性肝细胞癌(HCC)中的作用。方法随机抽取接受超声造影检查并经临床或病理确诊具有肝硬化背景的20例ICC患者(ICC组)和35例HCC患者(HCC组),进行超声造影定量分析,比较两组相关参数,评价超声造影定量分析的鉴别价值。结果超声造影定量分析显示,两组患者上升时间(RT)、达峰时间(TTP)比较,差异均无统计学意义(t=0.546、0.967,P>0.05);ICC组平均渡越时间(mTT)少于HCC组,灌注指数(PI)小于HCC组,差异均具有统计学意义(t=2.073、2.460,P<0.05)。2位医生主观判断的Kappa值为0.625,二者之间一致性好;定量分析的Kappa值为0.843,二者之间的一致性很好。主观判断的诊断准确性为83.6%,定量分析的诊断准确性为92.7%,比较差异无统计学意义(P>0.05),但定量分析的准确性高于主观判断。结论超声造影定量分析可直观地反映ICC和HCC的血流灌注情况,有助于肝硬化背景下ICC和HCC的鉴别,超声造影定量分析ICC的m TT少于HCC,PI小于HCC,有助于两种疾病的鉴别。Objective To explore effect of ultrasound contrast quantitative analysis in distinguishing intrahepatic cholangiocarcinoma （ICC） and primary hepatocellular carcinoma （HCC） in hepatic cirrhosis. Methods A total of 20 ICC patients （ICC group） and 35 HCC patients （HCC group） received ultrasound contrast quantitative analysis. They were all received ultrasound contrast examination and confirmed by clinic or pathology for hepatic cirrhosis. Relevant parameters were compared in two groups to evaluate distinguishing value of ultrasound contrast quantitative analysis. Results According to ultrasound contrast quantitative analysis, there were no statistically significant difference in rise time （RT）, time to peak （TTP） in two groups （t=0.546, 0.967, P〉0.05）. ICC group had less mean transit time （mTT） and perfusion index （PI） than HCC group, and their differences had statistical significance （t=2.073, 2.460, P〈0.05）. According to subjective judgment of 2 doctors, Kappa value was 0.625, with good consistency. Kappa value was 0.843 by quantitative analysis, with good consistency. The diagnostic accuracy of subjective judgment of was 83.6%, which was 92.7% by quantitative analysis. The difference had no statistical significance （P〉0.05）, but accuracy of quantitative analysis was higher than subjective judgment. Conclusion Ultrasound contrast quantitative analysis can intuitively reflect blood perfusion situation of ICC and HCC, which is helpful for distinguishing ICC and HCC in hepatic cirrhosis. The mTT and PI of ICC were shorter than that of HCC, and this is helpful to distinguish these two diseases.

关 键 词：超声造影 定量分析 肝内胆管细胞癌 原发性肝细胞癌 

分 类 号：R735[医药卫生—肿瘤] R575.2[医药卫生—临床医学] R445.1