超声造影检测肝癌高危患者早期微小肝癌的影像学比较研究  

A comparative study of contrast-enhanced ultrasonography in detecting early small hepatocellular carcinoma in high-risk patients with hepatocellular carcinoma

作　　者：茆静 朱宏英 杜合娟 王忠夏 MAO Jing;ZHU Hong-ying;DU He-juan(Department of Ultrasound,Wuxi No. 5 People's Hospital( Wuxi Jiangsu,214005) China)

机构地区：[1]无锡市第五人民医院超声科,江苏无锡214000 [2]无锡市第五人民医院传染科 [3]南京鼓楼医院普外科

出　　处：《中西医结合肝病杂志》2019年第3期254-256,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：江苏省自然科学基金-青年基金项目(No.BK20160118);南京医科大学科技发展项目(No.2013NJMU195)

摘　　要：目的:分析超声造影检测肝癌高危患者早期微小肝癌的影像学比较情况。方法:选择我院2013年6月至2018年9月在我院长期随诊的185例肝癌高危患者,分析患者肝内微小结节的常规超声和超声造影检查资料,分析≤2.0cm肝内实质性小病灶的实时超声造影结果。结果:185例肝癌高危患者经超声造影诊断共发现24例(24灶)微小肝癌患者,其中18例表现为"快进快出"增强模式(占75.0%),经手术及病理证实其中15灶为中度分化癌,2灶为高度分化癌,1灶为透明细胞癌,6例表现为"快进同出"增强模式(占25.0%),经手术及病理证实其中5灶为高度分化癌,1灶为透明细胞癌;透明细胞癌开始增强时间明显迟于中度分化癌及高度分化癌,组间比较差异具有统计学意义(P<0.05),高度分化癌的开始消退时间明显迟于中度分化癌,组间比较差异具有统计学意义(P<0.05)。结论:超声造影可观察到微小肝癌患者肿瘤内的血流灌注过程,显示不同分化程度的肝肿瘤增强方式及灌注特点,有助于提高患者肝硬化背景下微小肝癌的诊断率。Objective:To analyze the comparative of contrast-enhanced ultrasonography in detecting early small hepatocellular carcinoma in high-risk patients with hepatocellular carcinoma.Methods:Total of 185 cases of patients with high risk of liver cancer who received long-term follow-up treatment were selected from June 2013 to June 2016 in our hospital.The routine ultrasonography and contrast-enhanced ultrasonography of intrahepatic micronodules were analyzed, and real-time contrast-enhanced ultrasonography results of intrahepatic substantive small lesions less than 2.0 cm were analyzed.Results:185 cases of patients at high risk of liver cancer by ultrasound diagnosis were found 24 cases with small liver cancer, including 18 cases of "fast into fast out" enhanced mode(75.0%), which was confirmed by surgery and pathology, 15 focal of moderately differentiated carcinoma, 2 kitchen for highly differentiated carcinoma, 1 focal of clear cell carcinoma, 6 cases of "fast forward with the enhanced mode"(25.0%), which was confirmed by surgery and pathology, 5 stove is highly differentiated carcinoma, 1 kitchen of clear cell carcinoma;The enhancement time of transparent cell carcinoma was significantly later than that of moderately differentiated carcinoma and highly differentiated carcinoma, and the difference between groups was statistically significant(P<0.05).Meanwhile, the regression time of highly differentiated carcinoma was significantly later than that of moderately differentiated carcinoma, and the difference between groups was statistically significant(P<0.05).Conclusion:Contrast-enhanced ultrasonography can observe the blood flow perfusion process in the tumor of patients with microhepatocellular carcinoma, and show the enhancement mode and perfusion characteristics of liver tumors with different degrees of differentiation, which is helpful to improve the diagnostic rate of microhepatocellular carcinoma in the context of cirrhosis.

关 键 词：超声造影 肝癌高危患者 微小肝癌 

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]