不同分化程度原发性混合型肝癌的超声造影图像特征分析  

Analysis of contrast-enhanced ultrasound imaging features of primary combined hepatocellular cholangiocarcinoma with different degree of differentiation

作　　者：阮晓苗 杨静文 曹佳智 任佑祥 秦闻悦 凌文武[1] RUAN Xiaomiao;YANG Jingwen;CAO Jiazhi;REN Youxiang;QIN Wenyue;LING Wenwu(Department of Ultrasound Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院超声医学科,四川成都610041

出　　处：《临床超声医学杂志》2025年第2期116-121,共6页Journal of Clinical Ultrasound in Medicine

基　　金：四川省科技计划项目——重点研发项目(2020YFS0211)。

摘　　要：目的分析不同分化程度原发性混合型肝癌(CHC)的超声造影图像特征。方法选取我院经病理确诊的CHC患者57例,根据分化程度分为低分化组(22例)、中-低分化组(21例)、中分化组(14例),比较各组常规超声及超声造影图像特征的差异。结果(1)常规超声图像特征比较:各组病灶内部回声、内部回声均匀度、边界、形态、血流分级比较差异均无统计学意义;(2)超声造影图像特征比较:各组动脉期增强方式、廓清情况、门脉期及延迟期增强程度比较差异均有统计学意义(均P<0.05);其中,中分化组动脉期以整体均匀增强为主(85.71%),低分化组和中-低分化组以整体不均匀增强、环状增强为主(59.09%和66.67%、36.36%和23.81%),中分化组和中-低分化组以晚期廓清为主(均为85.71%),低分化组以早期廓清为主(50.00%);低分化组和中-低分化组门脉期、延迟期均以显著低增强为主(63.64%、72.73%和57.14%、66.67%),中分化组均以低增强为主(均为57.14%),差异均有统计学意义(均P<0.05)。各组动脉期增强程度比较差异无统计学意义。结论不同分化程度CHC的超声造影图像特征存有差异,通过分析不同分化程度CHC的超声造影图像特征可为术前决策提供参考。Objective To analyze contrast-enhanced ultrasound(CEUS)imaging features of primary combined hepatocellular cholangiocarcinoma(CHC)with different degree of differentiation.Methods A total of 57 patients with CHC diagnosed by pathology in our hospital were divided into poorly differentiated group(22 cases),moderately-poorly differentiated group(21 cases)and moderately differentiated group(14 cases)according to the degree of differentiation.The differences in conventional ultrasound and CEUS imaging features of each group were compared.Results①Comparison of conventional ultrasound imaging features:there were no significant differences in the internal echo,internal echo uniformity,boundary,morphology and blood flow grading among the groups.②Comparison of contrast-enhanced ultrasound imaging features:there were statistically significant differences in arterial phase enhancement mode,early washout,portal venous phase and delayed phase enhancement degree among the groups(all P<0.05).The arterial phase of the moderately differentiated group was dominated by uniform enhancement(85.71%),while the poorly differentiated group and the moderately-poorly differentiated group were dominated by overall uneven enhancement(59.09%,66.67%)and ring enhancement(36.36%,23.81%).In the poorly differentiation group,the early washout was the main(50.00%),while in the moderately differentiation group and the moderately-poorly differentiation group,the late washout was the main(both 85.17%).In the portal venous phase and delayed phase,the poorly differentiation group and the moderately-poorly differentiation group were mainly significantly low enhancement(63.64%,72.73%and 57.14%,66.67%),and the moderately differentiation group was mainly low enhancement(both 57.14%),the differences were statistically significant(all P<0.05).There was no statistically significant difference in enhancement degree in the arterial phase among the groups.Conclusion There are differences in contrast-enhanced ultrasound imaging features of CHC lesions with diffe

关 键 词：超声检查 造影剂 混合型肝癌 分化程度 

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]