超声造影在小肝癌诊断中的应用价值  

Value of Contrast-Enhanced Ultrasonography in the Diagnosis of Small Hepatocellular Carcinoma

作　　者：陈勇良[1] 吴小霞[2] 赵辉[2] 李振燕[2] 杜瑞清[2] 马春华[2] 耿建章[1] 陈蕾[1] CHEN Yongliang;WU Xiaoxia;ZHAO Hui;LI Zhenyan;DU Ruiqing;MA Chunhua;GENG Jianzhang;CHEN Lei(Department of Fifth Infection,The 6th Hospital of Shijiazhuang, Shijiazhuang Hebei 050021, China;Department of Function, The 6th Hospital of Shijiazhuang, Shijiazhuang Hebei 050021, China)

机构地区：[1]石家庄市第五医院感染五科,河北石家庄050021 [2]石家庄市第五医院功能科,河北石家庄050021

出　　处：《中国医疗设备》2017年第10期59-61,75,共4页China Medical Devices

摘　　要：目的探讨超声造影在小肝癌诊断中的应用价值。方法回顾性分析在石家庄市第五医院功能科行超声造影并经穿刺活检病理诊断<1.5 cm病变35例,分析其二维灰阶超声及超声造影特征。结果病灶大小显示,≤1 cm 9个,1.1 cm 5个,1.2 cm 5个,1.3 cm 6个,1.4 cm 10个;其中高回声病变8个,等回声1个,余26个为低回声,伴低回声晕者5个。超声造影显示快进快出18个,快进不出6个,等增强-退出1个,低-等-低增强1个,等增强4个,低-等增强3个,低增强2个。穿刺活检证实血管瘤3个,再生结节3个,不典型增生结节5个,肝细胞癌22个,腺癌1个,胆管细胞癌1个。常规超声及超声造影诊断小肝癌的敏感性、特异性、准确性分别为50.4%、66.7%、45.7%及89.6%、66.7%、62.8%。超声造影诊断小肝癌敏感性及准确性明显高于常规超声。结论超声造影能更好显示肝脏小肝癌微血管灌注特征,从而有效地进行良恶性病变的鉴别,大大提高小肝癌甚至微小肝癌的诊断准确率,具有很高的应用价值和发展前景。Objective To investigate the value of contrast-enhanced ultrasonography in diagnosis of small hepatocellular carcinoma(HCC).Methods A retrospective analysis including35cases with lesions less than1.5cm in the department of ultrasound the fifthhospital of Shijiazhuang was performed,and the characteristics of two-dimensional gray scale ultrasound and contrast-enhancedultrasound were analyzed.Results The size of lesions showed that9lesions were less than1cm,5lesions were1.1cm,5lesionswere1.2cm,6lesions were1.3cm and10lesions were1.4cm.The number of lesions with high-echo,iso-ehco and low-ehco were8,1and26,respectively.Among the patients with low-ehco,6were accompanied with faint.Contrast-enhanced ultrasonography(CEUS)showed that there were18lesions presented fast forward and rewind,6lesions presented fast forward and no rewind,1lesionspresented equal enhancement to exit,1lesion showed low to enhancement to low enhancement,4lesions showed enhancement,3lesions presented low enhancement to enhancement and2lesions showed low enhancement.The results of aspiration biopsyshowed that there were3hemangiomas,3regenerative nodules,5atypical hyperplasia nodules,22HCC,1adenocarcinoma,and1cholangiocarcinoma.The sensitivity,specificity and accuracy in the diagnosis of small hepatocellular carcinoma were50.4%,66.7%and45.7%for of conventional ultrasonography,and89.6%,66.7%,and62.8%for contrast-enhanced ultrasonographyrespectively.The sensitivity and accuracy of contrast-enhanced ultrasonography in diagnosis of small hepatocellular carcinoma werehigher than that of conventional ultrasound.Conclusion Compared with conventional ultrasound,CEUS can better display hepaticmicrovascular perfusion characteristics of small hepatocellular carcinoma,so it is effective in identification of benign and malignantlesions.Therefore this methods is of high application value and development prospects in improving the accuracy of diagnosis ofsmall hepatocellular carcinoma and small hepatocellular carcinoma.

关 键 词：肝硬化 局灶性结节 超声造影 小肝癌 穿刺活检 

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]