超声造影与磁共振诊断肝包膜下小肝癌的临床价值  

Evaluation of the Consistency Between Contrast-Enhanced Ultrasound and Magnetic Resonance in The Diagnosis of Small Subcapsular Liver Cancer

作　　者：杜佩[1] 葛欣 DU Pei;GE Xin(Baoji Hospital of Traditional Chinese Medicine,Baoji Shaanxi 721001)

机构地区：[1]宝鸡市中医医院超声科,陕西宝鸡721001 [2]宝鸡市人民医院超声科,陕西宝鸡721000

出　　处：《医学临床研究》2022年第12期1768-1770,1774,共4页Journal of Clinical Research

基　　金：延安大学附属医院科学技术研究发展计划项目(2021PT-18)。

摘　　要：【目的】探讨超声造影与磁共振成像(MRI)诊断肝包膜下小肝癌的临床价值。【方法】选取2019年7月至2021年9月宝鸡市中医医院收治的89例疑似肝包膜下小肝癌患者,所有患者均行超声造影、MRI检查,以病理诊断作为“金标准”。记录超声造影、MRI检查结果,分析超声造影、MRI诊断效能及一致性。【结果】89例疑似肝包膜下小肝癌患者共95个肝包膜下病灶,其中79个病灶(83.16%,79/95)经手术病理及穿刺病理检查证实为包膜下小肝癌。超声造影检查呈“快进快出”征象病灶77个(81.05%,77/95),小肝癌病灶的峰值强度(PI)高于良性病灶,小肝癌病灶的上升时间(RT)、达峰时间(PT)均低于良性病灶(P<0.05)。MRI诊断发现75个病灶(78.95%,75/95)动脉期信号明显强化、静脉期及平衡期信号下降、肝胆期呈现明显低信号,小肝癌病灶的峰值(PV)、最大上升斜率(MSI)、最大下降斜率(MSD)均低于良性病灶(P<0.05),小肝癌病灶的Kep值、Ktrans值、Ve均高于良性病灶(P<0.05)。病理诊断与超声造影、MRI诊断的一致性Kappa值分别为0.801、0.789,超声造影与MRI诊断的一致性Kappa值为0.806。【结论】超声造影、MRI诊断肝包膜下小肝癌效能类似,可根据个体情况合理选择适合诊断方法。【Objective】To contrast the value of contrast-enhanced ultrasound and magnetic resonance imaging(MRI)in the diagnosis of small hepatocellular carcinoma under the liver capsule.【Methods】89 patients with suspected small subcapsular liver cancer in Baoji Hospital of Traditional Chinese Medicine were selected as the research subjects from July 2019 to September 2021.All patients underwent contrast-enhanced ultrasound and MRI examination,and pathological diagnosis was used as the"gold standard".The results of contrast-enhanced ultrasound and MRI,analysis of contrast-enhanced ultrasound and MRI diagnostic efficiency and consistency were recorded.【Results】There were 95 subcapsular liver lesions in 89 patients with suspected small subcapsular liver cancer,of which 79 lesions(83.16%,79/95)were confirmed to be small subcapsular liver cancer by surgical pathology and puncture pathological examination.The contrast-enhanced ultrasound examination showed 77 lesions(81.05%,77/95)with"fast forward and fast exit"signs.The peak intensity(PI)of small liver cancer lesions was higher than that of benign lesions,and the rise time(RT)and peak time(PT)of small liver cancer lesions were lower than those of benign lesions(P<0.05).MRI diagnosis revealed that 75 lesions(78.95%,75/95)showed significant signal enhancement in the arterial phase,decreased signal in the venous phase and equilibrium phase,and significantly low signal in the hepatobiliary phase.The peak value(PV),maximum ascending slope(MSI),and maximum descending slope(MSD)of small liver cancer lesions were all lower than those of benign lesions(P<0.05),and the Kep value,Ktrans value and Ve value of small liver cancer lesions were higher than those of benign lesions(P<0.05).The consistency kappa values of pathological diagnosis,contrast-enhanced ultrasound and MRI diagnosis were 0.801 and 0.789,respectively,and the consistency kappa values of contrast-enhanced ultrasound and MRI diagnosis were 0.806.【Conclusion】Contrast-enhanced ultrasound and MRI have similar effi

关 键 词：肝肿瘤/影像诊断 磁共振成像 超声检查 

分 类 号：R735.7[医药卫生—肿瘤]