摘要
目的:观察原发性肝癌(PHC)超声造影(CEUS)血流灌注特点,探究其与PHC病理分化及肿瘤微血管密度(MVD)的关系。方法:选择经病理证实为PHC的120例患者,其中高分化病灶49个,中分化54个,低分化46个,术前均完成CEUS检查,观察CEUS定量血流灌注参数及时间-强度曲线形态特点,并将定量参数与术后病理组织分化程度及MVD进行比较,分析血流灌注参数与PHC病理特点的关系。结果:PHC患者动脉相149个病灶呈均匀或不均匀高强化,其中107个病灶呈均匀高强化,8个病灶呈周围高强化,34个病灶呈不均匀高强化;门静脉相138个病灶呈低强化,11个病灶呈等增强;延迟相149个病灶均呈低增强。低分化组、中分化组增强时间、始退时间、廓清时间均短于高分化组,平均血流密度(MFD)高于高分化组(P<0.05);低分化组增强时间、始退时间、廓清时间短于中分化组,MFD高于高分化组(P<0.05)。高分化PHC动脉相以放射样灌注模式为主,中分化以混合样为主,低分化以蛛网样为主(P<0.001)。混合样、放射样MVD低于蛛网样灌注模式,放射样MVD又低于混合样灌注模式(P<0.05)。MFD与MVD呈正相关(r=0.534,P<0.001),增强时间、达峰时间、廓清时间均与MVD呈负相关(r=-0.320、-0.308、-0.389,P<0.05)。结论:PHC患者CEUS参数MFD、增强时间、达峰时间、廓清时间均与PHC病理进展有关,CEUS检查有望与病理活检共同成为PHC微血管病变筛查的依据。
Aim:To observe the blood perfusion features of primary hepatocellular carcinoma(PHC)by contrast-enhanced ultrasound(CEUS)and explore its relationship with pathological differentiation and microvessel density(MVD).Methods:A total of 120 patients with PHC confirmed by pathology were selected,including 49 highly differentiated lesions,54 moderately differentiated lesions and 46 poorly differentiated lesions.All of them underwent CEUS before operation.The quantitative blood perfusion parameters of CEUS and morphological characteristics of time-intensity curve were observed,and the quantitative parameters were compared with postoperative histopathological differentiation and MVD.Relationship between blood perfusion parameters and pathological features of PHC was analyzed.Results:A total of 149 lesions in arterial phase of PHC patients showed uniform or non-uniform high enhancement.Among them,107 lesions showed uniform high enhancement,8 lesions showed high surrounding enhancement and 34 lesions showed non-uniform high enhancement.A total of 138 lesions in portal vein phase showed low enhancement and 11 lesions showed equal enhancement.A total of 149 lesions in delayed phase showed low enhancement.The enhancement time,retreat time and clearance time in poorly differentiated group and moderately differentiated group were shorter than those in highly differentiated group,while the mean blood flow density(MFD)was higher than that in highly differentiated group(P<0.05).The enhancement time,retreat time and clearance time in poorly differentiated group were shorter than those in moderately differentiated group,while the MFD was higher than that in highly differentiated group(P<0.05).The PHC arterial phase was mainly radial perfusion mode in highly differentiated group,the mixed type was mainly in moderately differentiated group,and the arachnoid type was mainly in poorly differentiated group(P<0.001).The mixed MVD and radial MVD was lower than that of arachnoid perfusion mode,and radial MVD was lower than that of mixed perf
作者
汪玲
陆英慧
王天佑
WANG Ling;LU Yinghui;WANG Tianyou(Department of Ultrasound,Zhumadian Central Hospital,Zhumadian,Henan 463000;Department of Ultrasound,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2020年第5期681-685,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省医学科技重大攻关项目(201703086)。
关键词
原发性肝癌
超声造影
血流灌注
病理分化
微血管密度
primary hepatocellular carcinoma
contrast-enhanced ultrasound
blood perfusion
pathological differentiation
microvessel density
