摘要
目的探讨彩色多普勒超声在肝细胞癌与胆管细胞癌诊断中的应用价值。方法选取原发性肝癌患者86例,按照病理类型分为肝细胞癌组和胆管细胞癌组。所有患者首先行常规超声检查,观察病灶大小、位置、形态、数量、边界等声图表现,检查门静脉主干及肝内分支管腔的清晰程度,实体回声情况。彩色多普勒超声探测肝动脉及门静脉主干血流情况,记录HA、SMA、PV血流频谱,测量HA的PAV、EDV、MV、RI,SMA及PV的Vm,计算各血管每分钟血流量。比较两组超声影像学资料。结果两组患者的肿瘤在左肝、右肝、左右肝及肝门均有分布,且两组的分布情况没有显著性差异(P>0.05);肝细胞癌单发与多发差异不显著,胆管细胞癌则是以单发为主(P<0.05)。两组肝固有动脉的EDV、Qh、肠系膜上动脉的Qs及门静脉主干的Vm、Qp间均无显著差异(P>0.05),胆管细胞癌组患者HA的PSV、RI、SMA的Vm显著高于肝细胞癌组患者(P<0.05)。肝细胞癌组彩色多普勒超声显示,肿块内的血液丰富,肝动脉供血为主,肝实质回声增粗,附近血管受压、绕行现象明显;胆管细胞癌组图像显示,肿块无明显边界,内部血管不丰富,可见变窄的血管穿行,病变处门静脉分支不清晰。结论彩色多普勒超声科在诊断和鉴别肝细胞癌及胆管细胞癌上具有重要的临床价值。
Objective To explore the value of color Doppler ultrasound in the diagnosis of hepatocellular carcinoma and cholangiocarcinoma. Methods 86 patients with primary hepatocellular carcinoma were selected,and the pathological types were divided into hepatocellular carcinoma group and cholangiocarcinoma group. All patients received routine ultrasound examination.The lesion size,location,shape,number,boundaries and other sonograms were observed. The clarity and physical echo of portal vein and intrahepatic branch lumen were checked. The hepatic artery and portal vein blood flow were detected by color Doppler ultrasound. Doppler waveform of HA,SMA and PV blood flow were recorded. PAV,EDV,MV,RI of HA,Vm of SMA and PV were measured. HA,SMA and PV blood flow per minute were calculated. Both groups of ultrasound imaging data were compared. Results Tumours of the 2 groups in the left liver,right liver,liver and portal are distributed. There was no significant difference between the 2 groups of distribution of tumor（ P〉0. 05）. Hepatocellular carcinoma single and multiple differences were not significant. Cholangiocarcinoma was single-based（ P〈0. 05）. There were no significant differences in EDV and Qh of HA,Qs of SMA,Vm and Qp of PV between the 2 groups（ P〉0. 05）. The PSV and RI of HA,Vm of SMA and PV of cholangiocarcinoma group were higher than those of the hepatocellular carcinoma group（ P〈0. 05）. Color Doppler echocardiography in hepatocellular carcinoma showed that the mass of blood in the tumor mass was mainly in the hepatic artery,the echogenic mass in the liver parenchyma was thick,and the nearby vessel was compressed and the phenomenon of detour was obvious. Cholangiocarcinoma group images showed no obvious border mass,the internal vascular was not rich,narrowing of blood vessels can be seen through,the lesion at the portal vein was not clear. Conclusion Color Doppler ultrasound in the diagnosis and identification of hepatocellular carcinoma and cholangiocarcinoma has important clinical value.
作者
邢艳丽
申健
XING Yanli;SHEN Jian(Xi＇an Medical College Second Affiliated Hospital,Xi＇an,710038)
出处
《实用癌症杂志》
2018年第9期1521-1523,共3页
The Practical Journal of Cancer
关键词
肝细胞癌
胆管细胞癌
彩色多普勒超声
Hepatoeellular carcinoma
Cholangioeareinoma
Color Doppler ultrasound
