小肝癌超声造影影像学表现与分化程度、病理类型的相关性分析  

Correlation between Imaging Features of Contrast-enhanced Ultrasonography of Small Hepatocellular Carcinoma and the Degree of Differentiation and Pathological Type

作　　者：李艳 朱冬梅 刘刚[1] 张慧 刘学彬 LI Yan;ZHU Dong-mei;LIU Gang;ZHANG Hui;LIU Xue-bin(Department of Ultrasound,Nanchong Central Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]南充市中心医院超声科,四川南充637000

出　　处：《解放军医药杂志》2020年第4期29-32,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(16PJ201);四川省教育厅科研计划项目(17ZB0176);南充市应用技术研究与开发资金项目(16YFZJ0024);川北医学院科研发展计划项目资助(CBY17-A-YB45,CBY17-A-YB19,CBY16-A-YB37)。

摘　　要：目的分析小肝癌超声造影影像学表现与分化程度、病理类型的相关性。方法回顾性分析2017年4月—2019年10月收治的73例小肝癌患者的临床资料,比较不同分化程度、病理类型的小肝癌造影动脉相、门脉相、延迟相增强模式;比较不同分化程度的小肝癌造影剂开始增强时间、达峰时间和消退时间。结果小肝癌超声增强模式呈“快进快出”,随着小肝癌分化程度的降低,造影剂开始增强时间、达峰时间、消退时间也逐渐缩短。高分化和中分化小肝癌消退时间长于低分化,高分化长于中分化(P<0.05)。梁索型、假腺管型、实体型小肝癌动脉相增强模式以高增强为主,门脉相、延迟相均以低增强为主,为典型的“高-低-低”的“快出快进模式”;纤维硬化型小肝癌呈“快进慢出”的特征。不同病理类型小肝癌门脉相、延迟相小肝癌增强模式比较差异有统计学意义(P<0.05)。结论超声造影检查可有效显示小肝癌的影像学特点,其影像学表现与小肝癌分化程度及病理类型具有一定的相关性,可为临床上初步诊断小肝癌提供可靠的依据。Objective To analyze the correlation between the imaging features of contrast-enhanced ultrasonography(CEUS)of small hepatocellular carcinoma(HCC)and the degree of differentiation and pathological type.Methods The clinical data of 73 patients with small HCC who were admitted to our hospital from April 2017 to October 2019 were retrospectively analyzed.The enhancement patterns of arterial phase,portal phase and delayed phase of contrast agents of small HCC with different degrees of differentiation and pathological types were compared.The contrast enhancement time,peak time and regression time of contrast agents of small HCC with different degrees of differentiation were compared.Results The ultrasound-enhanced mode of small HCC showed"fast in and fast out".As the differentiation degree of small HCC was decreased,the enhancement time,peak time and regression time of contrast agent were gradually shortened.The regression time of well-and moderately-differentiated small HCC was longer than that of poorly-differentiated small HCC,and the regression time was longer in well-differentiated HCC than in moderately-differentiated small HCC(P<0.05).The enhancement mode of the arterial phase of the beam-type,pseudoglandular,and solid small HCC was mainly high-enhancement,and enhancement mode of the portal phase and delayed phase was mainly low-enhancement,which was typical"fast in fast out"mode of"high-low-low".Small HCC due to fibrosis was characterized by"fast in and slow out".There was significant difference between portal vein phase and delayed phase of small HCC with different pathological types(P<0.05).Conclusion CEUS can effectively reveal the imaging features of small HCC,which was correlated with the degree of differentiation and pathological types of small HCC.Therefore,this can provide a reliable basis for the clinical diagnosis of small HCC.

关 键 词：肝肿瘤 超声造影 分化程度 动脉相 门脉相 延迟相 病理类型 

分 类 号：R735.7[医药卫生—肿瘤]