超声造影在微小肝细胞肝癌诊断中的应用价值  

Application value of contrast-enhanced ultrasound in the diagnosis of small hepatocellular carcinoma

作　　者：卓涛[1] 陈海燕[2] 陈冬梅[1] 李坚[1] ZHUO Tao;CHEN Hai-yan;CHEN Dong-mei(2.Department of Ultrasound,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning Guangxi 541000,China)

机构地区：[1]广西壮族自治区玉林市第一人民医院超声科,广西玉林537000 [2]广西壮族自治区人民医院超声科,广西南宁541000

出　　处：《临床和实验医学杂志》2019年第7期766-769,共4页Journal of Clinical and Experimental Medicine

基　　金：玉林市科学研究与技术开发计划项目(编号:玉市科攻1421043)

摘　　要：目的探讨超声造影在微小肝细胞肝癌诊断中的应用价值。方法对156例高危微小肝细胞肝癌患者进行常规超声、超声造影、增强CT扫描和病理组织活检,比较灵敏度和特异度。观察肝内病灶在超声造影不同时相的增强表现特点。结果 156例高危患者中微小肝癌87例,超声造影检查的灵敏度和特异度分别为78.16%和74.71%,均高于常规超声(48.28%和50.57%)和增强CT(65.52%和59.77%),差异有统计学意义(P <0.05)。87例微小肝癌患者中,71例(81.61%)超声造影增强模式表现为"快进快出"型,即动脉相病灶高增强,门脉相或延迟相消退为低回声; 16例(18.39%)表现为"快进同出"型,其中直径<1 cm者占68.75%(11/16)。结论超声造影对微小肝癌的诊断效能高于常规超声和增强CT,但仍存在一定的漏诊率。Objective To investigate the application value of contrast-enhanced ultrasound in the diagnosis of small hepatocellular carcinoma.Methods The sensitivity and specificity of conventional ultrasonography,contrast-enhanced ultrasonography,enhanced CT scan and pathological biopsy were compared in 156 patients with high-risk micro-hepatocellular carcinoma.The enhancement features of hepatic lesions in different phases of contrast enhanced ultrasound were observed.Results The sensitivity and specificity of contrast-enhanced ultrasonography were higher than that of conventional ultrasonography and contrast-enhanced CT in 87 of 156 high-risk patients(P<0.05).Among 87 patients with small hepatocellular carcinoma,71(81.61%)had a"fast-in and fast-out"mode of contrast-enhanced ultrasonography,i.e.high enhancement in arterial phase,low echo in portal phase or delayed phase,and 16(18.39%)had a"fast-in and fast-out"mode,of which 68.75%(11/16)had a diameter less than 1 cm.Conclusion Contrast-enhanced ultrasound is more effective than conventional ultrasound and enhanced CT in the diagnosis of small hepatocellular carcinoma,but there is still a certain rate of missed diagnosis.

关 键 词：微小肝细胞肝癌 超声 超声造影 增强CT 

分 类 号：R445.1[医药卫生—影像医学与核医学]