肺癌肝转移瘤超声造影表现与病理组织类型的对照研究  

Contrast-enhanced ultrasonography characteristics of liver metastasis correlation with different pathological type of lung cancer

作　　者：黄鑫[1] 陈文卫[1] 孙彬[1] 胡伟[1] 曾智[2] 黄星月[1] 张隽 张瑶 饶洁[2] Huang Xin;Chen Wenwei;Sun Bin;Hu Wei;Zeng Zhi;Huang Xingyue;Zhang Jun;Zhang Yao;Rao Jie(Department of Ultrasound,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院超声影像科,430060 [2]武汉大学人民医院病理科,430060

出　　处：《中华超声影像学杂志》2020年第7期602-607,共6页Chinese Journal of Ultrasonography

摘　　要：目的:通过分析肺癌肝转移瘤超声造影(CEUS)特征,探讨CEUS对肺癌肝转移瘤的诊断价值。方法:选取2014年1月至2019年3月于武汉大学人民医院超声影像科就诊的肺癌肝转移瘤患者78例,其中腺癌30例,鳞癌20例,神经内分泌肿瘤28例,分析肝肿瘤二维超声及CEUS表现特点。结果:CEUS示85.9%(67/78)病灶为"快进"模式,89.7%(70/78)为"快退"模式,三组间差异无统计学意义( P>0.05)。腺癌和鳞癌组以环状增强方式为主,分别为53.3%(16/30)、55.0%(11/20),而神经内分泌肿瘤组71.4%(20/28)为整体增强,与其他两组比较差异有统计学意义(均 P<0.05)。达峰时多数病灶呈现高增强,但神经内分泌肿瘤组73.7%(14/19)为整体增强方式,而腺癌组75.0%(12/16)和鳞癌组72.7%(8/11)为环状增强方式,差异有统计学意义( P<0.05)。达峰时神经内分泌肿瘤组67.9%(19/28)病灶增强均匀,仅21.4%(6/28)病灶内部出现无增强区,与其他两组比较差异有统计学意义(均 P<0.05)。神经内分泌肿瘤组病灶消退为等增强时间,为(33.2±7.6)s,大于腺癌组和鳞癌组的(29.2±7.4)s、(27.5±6.5)s(均 P<0.05);神经内分泌瘤组消退为低增强时间,为(45.1±10.8)s,也大于其他两组[腺癌组(39.8±10.1)s、鳞癌组(36.3±8.3)s](均 P<0.05)。在延迟期,神经内分泌肿瘤组32.1%(9/28)病灶出现包膜增强征象,高于其他两组[腺癌组13.3%(4/30)、鳞癌组10.0%(2/20)],差异有统计学意义(均 P<0.05)。 结论:应用CEUS对肺癌肝转移瘤的临床鉴别诊断具有一定价值。Objective To provide objective basis for the diagnosis on liver metastasis from lung cancer by analysing contrast-enhanced ultrasonography(CEUS)characteristics.Methods In a reprospective study,CEUS was performed in 78 cases with liver metastasis from lung cancer in Renmin Hospital of Wuhan University from January 2014 to March 2019.Patients were divided into three groups:the adenocarcinoma group(n=30),squamous cell carcinoma group(n=20),and neuroendocrine neoplasm group(n=28).Conventional ultrasound and CEUS features were analyzed and the distinctions among the three groups were compared.Results CEUS showed that 85.9%(67/78)of the liver metastasis from lung cancer with pattern of rapid wash-in and 89.7%(70/78)of rapid wash-out,so there was no statistical difference among the three groups(P>0.05).In the adenocarcinoma and squamous cell carcinoma group,53.3%(16/30)and 55.0%(11/20)of cases were rim-like enhancement.And 71.4%(20/28)of the neuroendocrine neoplasm group with global enhancement that was different from the other groups(all P<0.05).At the peak of enhancement,most cases were hyperenhancement among the three groups,and the difference was not statistically significant(P>0.05).During the lesions of hyperenhancement,73.7%(14/19)was global enhancement in the neuroendocrine neoplasm,compared to 75.0%(12/16)of the adenocarcinoma group and 72.7%(8/11)of the squamous cancer group with rim-like enhancement,which the differences was statistically significant(all P<0.05).At the peak of enhancement,67.9%(19/28)lesions of the neuroendocrine neoplasm group were homogeneous enhancement,and only 21.4%(6/28)of the lesions was observed non-enhanced area,which was different from the other groups(all P<0.05).The times to iso-echogenity and hypo-echogenity were(33.2±7.6)s and(45.1±10.8)s respectively in the neuroendocrine neoplasm group,which were more than the other groups(all P<0.05).Capsule enhancement appeared in 32.1%(9/28)of the neuroendocrine neoplasm group in the delay phase,which was higher than 13.3%(4/30)of the ade

关 键 词：超声检查 造影剂 肝肿瘤 肺癌 肿瘤转移 

分 类 号：R734.2[医药卫生—肿瘤]