超声造影对不同分化程度肝硬化合并小肝癌的诊断价值  

Diagnostic Value of Contrast-enhanced Ultrasound in Cirrhosis with Small Hepatocellular Carcinoma of Different Differentiation

作　　者：刘元锋[1] 余晓梅[1] 戴旭辉[1] 杨捷 Liu Yuanfeng;Yu Xiaomei;Dai Xuhui;Yang Jie(Wuhan First Hospital(Wuhan Hospital of Traditional Chinese and Western Medicine),Wuhan,Hubei 430000,China)

机构地区：[1]武汉市第一医院(武汉市中西医结合医院)超声影像科,武汉市430000

出　　处：《中国超声医学杂志》2021年第6期659-662,共4页Chinese Journal of Ultrasound in Medicine

基　　金：湖北省卫生计生委科研项目(No.WJ2017MB143)。

摘　　要：目的探讨超声造影对不同分化程度肝硬化合并小肝癌的诊断价值。方法选取本院收治的84例疑为肝硬化合并小肝癌患者,均早期行超声造影检查,对比病理结果分析超声造影对不同分化程度小肝癌的诊断价值。结果超声造影诊断出小肝癌127个,肝良性肿块60个。对比病理结果,超声造影对小肝癌的诊断灵敏度、特异度、准确度、约登指数、阳性似然比、阴性似然比分别为98.39%、92.06%、96.26%、0.93、12.39、0.017。小肝癌超声造影特征以“快进快出”为主(89.52%),肝脏良性病变以“慢进同出”为主(87.30%)。高分化癌灶的开始增强时间、达峰时间、开始廓清时间均明显比低分化癌更长,达峰时间、开始廓清时间均明显比中分化癌灶更长(P<0.05)。结论不同分化程度肝硬化合并小肝癌的超声造影特征明显,超声造影对肝硬化合并小肝癌及其病理分化程度的评价及诊断有较高的诊断准确度。Objective To investigate the diagnostic value of parameters of contrast-enhanced ultrasonography(CEUS)in cirrhosis with small hepatocellular carcinoma of different differentiation.Methods 84 patients with suspected cirrhosis and small hepatocellular carcinoma were examined by CEUS in the early stage.The diagnostic value of CEUS for small hepatocellular carcinoma with different degrees of differentiation was analyzed by comparing the pathological results.Results 127 small liver cancer and 60 benign liver masses were diagnosed by contrast-enhanced ultrasound.The sensitivity,specificity,accuracy,yoden index,positive likelihood ratio and negative likelihood ratio of CEUS in the diagnosis of small hepatocellular carcinoma were 98.39%,92.06%»96.26%,0.93,12.39 and 0.017,respectively.The contrast-enhanced ultrasound features of small hepatocellular carcinoma were mainly“fast in and fast out”(89.52%),while the benign liver lesions were mainly“slow in and out”(87.30%).The time of enhancement,peak and clearance of well differentiated carcinoma were significantly longer than those of poorly differentiated carcinoma.and the time to peak and start clearance were significantly longer than those of moderately differentiated carcinoma(P<0.05).Conclusions CEUS has obvious features in cirrhosis with small hepatocellular carcinoma of different differentiation degrees.CEUS has high diagnostic accuracy in evaluating and diagnosing the degree of pathological differentiation of cirrhosis with small hepatocellular carcinoma.

关 键 词：超声造影 分化程度 肝硬化 小肝癌 

分 类 号：R575.2[医药卫生—消化系统] R735.7[医药卫生—内科学] R445.1[医药卫生—临床医学]