超声造影在肝癌肝移植术后复发病灶中的诊断价值  

Diagnostic value of contrast-enhanced ultrasonography in recurrent lesions of hepatocellular carcinoma after liver transplantation

作　　者：高农 王冬丽 吕发勤 黄振俊 任秀昀 Gao Nong;Wang Dongli;Lv Faqin;Huang Zhenjun;Ren Xiuyun(Department of Ultrasound,the Third Medical Center of PLA General Hospital,Beijing 100039,China;Department of Rehabilitation,Hainan Hospitalof PLA General Hospital,Sanya 572013,Hainan,China;Department of Ultrasound,Hainan Hospitalof PLA General Hospital,Sanya 572013,Hainan,China)

机构地区：[1]中国人民解放军总医院第三医学中心超声诊断科,北京100039 [2]中国人民解放军总医院海南医院康复诊疗科,海南三亚572013 [3]中国人民解放军总医院海南医院超声诊断科,海南三亚572013

出　　处：《实用器官移植电子杂志》2022年第6期537-540,共4页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：北京市自然科学基金(7212139);海南省自然科学基金(821MS0821)。

摘　　要：目的探讨肝癌肝移植术后移植肝复发病灶的超声造影增强模式及诊断价值。方法回顾性分析解放军总医院第三医学中心器官移植科2007年10月至2022年1月,术前临床诊断原发性肝癌行肝移植术后肝癌复发并经病理证实的124例患者病例资料,分析复发灶超声造影增强模式及诊断肝癌复发的灵敏度、特异度、阳性预测值、阴性预测值、准确性,并采用线性加权Kappa检验对超声造影诊断结果与病理诊断结果进行一致性分析。结果病理诊断移植肝脏肿瘤复发124例,其中单发病灶59例,多发病灶65例。超声造影模式:动脉期高增强96例,等增强型16例,低增强12例,快进快出106例,快进慢出5例,等进快出11例,等进慢出2例。超声造影诊断移植肝肝癌复发的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别为97.6%、97.4%、98.4%、96.2%、97.5%。对超声造影诊断结果与病理诊断结果进行一致性分析,Kappa值为0.948(P<0.001)。结论超声造影诊断结果与病理诊断一致性较好,超声造影根据其特征性增强模式,对肝癌肝移植后移植肝复发病灶的明确诊断具有重要临床价值。Objective To explore the contrast-enhanced mode and diagnostic value of contrast-enhanced ultrasonography in recurrent lesions of hepatocellular carcinoma after liver transplantation.Methods A total number of 124 liver transplant recipients with pathological confirmed liver cancer recurrence in the Organ Transplantation Department of the Third Medical Center of PLA General Hospital from October 2007 to January 2022 were selected as the objects of study.The contrast-enhanced mode and contrast-enhanced ultrasound diagnosis of recurrent liver cancer were analyzed and compared with pathology.Four tables were used to calculate the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of contrast-enhanced ultrasound in the diagnosis of liver cancer recurrence after liver transplantation.Linear weighted Kappa test was used to analyze the consistency between contrast-enhanced ultrasound and pathological diagnosis.Results A total number of 124 cases of liver tumor recurrence were diagnosed pathologically,including 59 cases of single lesion and 65 cases of multiple foci.Contrast-enhanced ultrasound mode:arterial phase high enhancement in 96 cases,equal enhancement in 16 cases,low enhancement in 12 cases,fast in and fast out in 106 cases,fast in and slow out in 5 cases,equal in and slow out in 11 cases,equal in and slow out in 2 cases.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of contrast-enhanced ultrasound in the diagnosis of recurrence were 97.6%,97.4%,98.4%,96.2%and 97.5%,respectively.The results of contrast-enhanced ultrasound and pathological diagnosis were consistent,and the Kappa value was 0.948(P<0.001).Conclusion The results of contrast-enhanced ultrasonography are consistent with pathological diagnosis.According to its characteristic enhancement mode,contrast-enhanced ultrasound has important clinical value in the diagnosis of recurrent liver tumor after liver transplantation.

关 键 词：原发性肝癌 超声造影 肝移植 肝癌复发 

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]