肝肉瘤样癌的超声造影表现  

Analysis of the contrast-enhanced ultrasonic characteristics of sarcomatoid hepatoceilular carcinoma

作　　者：董彩虹 王文平 季正标 曹佳颖 丁红 黄备建 Dong Caihong; Wang Wenping; Ji Zhengbiao; Cao Jiaying; Ding Hong; Huang Beijian(Department of Ultrasound, Zhongshan Hospital ＆ Shanghai Institute of Medical Imaging, Fudan University, Shanghai 200032, China)

机构地区：[1]复旦大学附属中山医院超声科上海市影像医学研究所,上海200032

出　　处：《中华超声影像学杂志》2018年第10期855-859,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81371577,81571676）

摘　　要：目的探讨肝肉瘤样癌的超声造影表现。方法回顾性分析15例经病理证实的肝肉瘤样癌患者的超声造影表现，按病灶是否呈整体肉瘤样变，分为整体肉瘤样变组（9个病灶）和部分肉瘤样变组（6个病灶）；按病灶大小，分为小病灶组（最大径〈50mm，共8个病灶）和大病灶组（最大径≥50mm，共7个病灶）；观察和比较不同组间的超声造影表现。结果超声造影动脉期，整体肉瘤样变组均表现为环状高增强，部分肉瘤样变组均表现为整体高增强，组间差异有统计学意义（P〈0．001）；小病灶组和大病灶组超声造影的动脉期表现差异无统计学意义（P=0．608）。所有病灶在动脉期显示高增强的部分在门脉期和（或）延迟期均表现为低回声。结论肝肉瘤样癌的超声造影表现与肿瘤大小无关，与肿瘤内肉瘤样变的程度有关。超声造影动脉期，整体肉瘤样变的肝肉瘤样癌显示为环状高增强，部分肉瘤样变的肝肉瘤样癌显示为整体高增强。Objective To explore the characteristics of contrast-enhanced ultrasonagraphy（CEUS） of sarcomatoid hepatocellular carcinoma（SHC）. Methods Fifteen lesions identified pathologically from 15 patients were included in this study. Among them, 9 lesions had completely sarcomatoid change and 6 lesions had partially sarcomatoid change. Totally 8 lesions were in the small size group with maximum diameter 〈50 mm and 7 lesions in the big size group with maximum diameter≥ 50 mm. The CEUS performance was observed and analyzed. Results In the arterial phase of CEUS,9 lesions in the group with completely sarcomatoid change showed rim hyperenhancement and 6 lesions in the group with partially sarcomatoid change showed whole hyperenhancement, the difference between the two groups was statistically significant （P 〈0.001 ）. However, the difference of CEUS performance between small size group and big size group was not statistically significant （P = 0.608）, all the lesions showed hypoechogenecity in portal and（or） late phase of CEUS. Conclusions The difference of performance on CEUS is not related to the size of SHC, but to the degree of sarcomatoid change within the tumor. SHC with completely sarcomatoid change shows rim hyperenhancement and SHC with partially sarcomatoid change shows entire hyperenhancement in arterial phase on CEUS.

关 键 词：超声造影 肝肿瘤 肝肉瘤样癌 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]