慢性血吸虫性肝病合并肝癌的超声图象分析  

Ultrasonographic Analysis of Chronic Schistosomiasis Liver Disease Complicated with Hepatocellular Carcinoma

作　　者：董昌兰 DONG Chang-lan(Color Doppler Ultrasound Room,Suzhou Industrial Park Xingpu Hospital,Suzhou Jiangsu 215123)

机构地区：[1]苏州工业园区星浦医院彩超室,江苏苏州215123

出　　处：《智慧健康》2019年第9期1-2,共2页Smart Healthcare

摘　　要：目的观察并分析慢性血吸虫性肝病合并肝癌患者的声像图表现,发现其特点,为鉴别诊断提供帮助。方法回顾性分析了32例慢性血吸虫性肝病合并肝癌患者的超声图像报告,先从整体观察肝脏的大小,形态,肝内的管道结构走形;再仔细观察占位性病变的细微结构及其周围组织的改变。结果慢性血吸虫性肝病中7例肝脏形态正常,25例出现肝右叶缩小,左叶增大,表面高低不平,肝脏回声呈网格状改变,其间回声高低不均。单发性占位性病变15例(占46.9%),多发性占位17例(占53.1%);其中肝左叶7例,肝右叶19例,肝左右两叶6例;占位性病变最小为(1.0×1.1)cm2,最大为(12.6×7.6)cm2。本组32例患者中,共有50个占位,其中27个呈现出低回声(18个占位周围出现低回声的"声晕征");21个呈高回声,等回声及混合回声各有1个。此外,16个占位的周围存在带状高回声包绕。结论慢性血吸虫性肝病合并肝癌时对识别和诊断造成一定的困难,但仔细辨认肿瘤的球体感能与血吸虫性肝病的网格状结构进行鉴别。Objective To observe and analyze ultrasonographic features of chronic schistosomiasis hepatopathy patients complicated with hepatocellular carcinoma(HCC),to find out its characteristics,and provide help for differential diagnosis.Methods Review and analzye ultrasound images report of 32 cases chronic schistosomiasis hepatopathy patients complicated with hepatocellular carcinoma.Observe size and shape of liver gernerally,and intrahepatic duct,micro-structure and surrounding tissues changes of space-occupying lesions carefully.Results 7 cases had normal liver shape among chronic schistosomiasis hepatopathy,25 cases showed reduced right lobe of liver,enlarged left lobe,uneven surface,grid-shaped changes of uneven liver echo.15 cases showed sporadic space occupying lesions(46.9%)and 17 cases of multiple space occupying lesions(53.1%).Among them,7 cases of left lobe,19 cases of right lobe and 6 cases of left and right lobes.The minimum space occupying lesion was(1.0×1.1)cm2 and the maximum was(12.6×7.6)cm2.Among 32 cases,there were 50 occupancies,of which 27 showed hypoecho(hypoechoic'halo sign'showed around 18 occupancies),21 showed hyperecho,1 isoecho and 1 mixed echo respectively.In addition,banded high echo surrounds 16 occupants.Conclusion It is difficult to identify and diagnose chronic schistosomiasis hepatopathy with hepatocellular carcinoma,but spherical sensation of tumors can differentiate it from grid structure of schistosomiasis hepatopathy.

关 键 词：慢性血吸虫性肝病 肝癌 超声图像 

分 类 号：R532.21[医药卫生—内科学] R735.7[医药卫生—临床医学]