超声检查对肝炎性假瘤与小肝癌的鉴别价值分析  

Clinical Value of Ultrasonography in the Differential Diagnosis of Hepatitis B and Small Hepatocellular Carcinoma

作　　者：邱丽娜[1] 肖秋金[1] 

机构地区：[1]中国人民解放军第九四医院,330002

出　　处：《实用癌症杂志》2017年第11期1860-1862,共3页The Practical Journal of Cancer

摘　　要：目的探讨超声用于鉴别诊断肝炎性假瘤与小肝癌的临床价值。方法选择就诊的患者122例,均在行常规腹部超声时发现肝内占位性病变,经病理确诊。常规先用二维超声对肝脏进行多切面扫查,发现病灶即记录病灶大小、回声、形态、部位等。然后利用多普勒血流显像(CDFI)及能量多普勒(CDE)观察肿块血流情况,检测肝动脉及肿块的血流动力学参数,测量其峰值血流速度(PSV)和阻力指数(RI)。结果 36例肝炎性假瘤患者肝脏大小和形态轮廓均未出现明显改变,形状以类圆形和椭圆形为主,病变位于汇管区22例(61.1%)。86例小肝癌患者中肝脏增大15例(17.4%),病灶以圆形和椭圆形为主,69例(80.2%)有声晕,后方回声轻度增强。小肝癌患者中低回声比例高于肝炎性假瘤,高回声和混合回声比例低于肝炎性假瘤,差异有统计学意义(P<0.05)。小肝癌内部及周边CDFI和CDE的血流显示率高于肝炎性假瘤,差异有统计学意义(P<0.05)。小肝癌内部及周边PSV和RI高于肝炎性假瘤,差异有统计学意义(P<0.05)。小肝癌肝动脉PSV低于肝炎性假瘤,RI高于肝炎性假瘤,差异有统计学意义(P<0.05)。结论超声鉴别诊断肝炎性假瘤与小肝癌可从肝脏形态、病灶回声、声晕和血流情况分析,具有一定的临床价值。Objective To investigate the clinical value of uhrasonography in the differential diagnosis of hepatitis B and small hepatocellular carcinoma. Methods 122 cases of patients with liver lesions confirmed by pathological diagnosis were se- lected. Liver received two-dimensional ultrasound scanning, found and record the size, echo, shape, and location of the lesions. Then, used the Doppler flow imaging （CDFI） and power Doppler （CDE） to observe the tumor blood flow, detected hemodynamic parameters of hepatic artery and the masses, and measured the peak systolic velocity （PSV） and resistance index （RI）. Results There were no significant changes in the size and shape of the liver in 36 patients with inflammatory pseudo-tumor of the liver, and the shape of the liver was mainly round and oval shape. The lesions located in the portal area in 22 cases （61, 1% ）. There were 15 cases of patients appeared liver volume increase, the lesions were mainly round and oval,69 cases （80.2%） had sound halo, and the rear echo was slightly enhanced. The proportion of low echo in patients with small hepatocellular carcinoma was higher than that of inflammatory pseudo-tumor of the liver, and the proportion of high echo and mixed echo was lower than that of inflam- matory pseudo-tumor of the liver, and the difference was statistically significant （ P 〈 0.05 ）. The blood flow rate of CDFI and CDE in small hepatocellular carcinoma was higher than that of inflammatory pseudo-tumor of the liver, and the difference was statistical- ly significant （P 〈 0.05 ）. The internal and peripheral PSV and RI of small hepatocellular carcinoma were significantly higher than that of inflammatory pseudo-tumor of the liver, and the difference was statistically significant （ P 〈 0.05 ）. The hepatic artery PSV of small hepatocellular carcinoma was lower than that of inflammatory pseudo-tumor of the liver, RI was higher than that of inflammatory pseudo-tumor of the liver, and the difference was statistically significant �

关 键 词：肝炎性假瘤 小肝癌 超声 血流参数 

分 类 号：R735.7[医药卫生—肿瘤]