摘要
目的:探讨肝硬化伴小肝癌(SHCC)的超声造影(CEUS)特征,分析CEUS对SHCC与不典型增生结节(DN)的鉴别诊断效能。方法:选择医院收治的78例术前均行GEUS检查的肝硬化患者,将肝硬化伴SHCC病灶患者分为SHCC组(55例,62个病灶),将DN病灶患者分为DN组(23例,32个病灶),观察比较两组患者病灶CEUS各时相增强模式、灌注模式及时间-强度曲线(TIC)参数。结果:SHCC组患者CEUS动脉相主要为高增强,而DN组患者CEUS主要为低增强;SHCC组病灶与DN组病灶的动脉相(高、等、低)、门脉相和延迟相(等、低)增强水平比较,差异有统计学意义(χ^(2)=69.124,χ^(2)=8.993,χ^(2)=52.392;χ^(2)=32.566,χ^(2)=32.566;x^(2)=34.873,χ^(2)=34.873;P<0.05)。SHCC病灶的灌注模式以高-低-低为主,而DN病灶灌注模式复杂多样;两组灌注模式比较差异有统计学意义(Z=70.450,P<0.05)。SHCC病灶TIC以“快上快下”为主,而DN病灶以“慢上慢下”为主;SHCC组的达峰时间、降支减半时间及持续增强时间均显著低于DN组,差异有统计学意义(t=5.349,t=7.020,t=25.966;P<0.05)。结论:SHCC具有典型CEUS图像特征,结合三期增强模式及TIC参数可为肝硬化基础上SHCC与DN的早期鉴别诊断提供依据。
Obective:10 investigate tne features of contrast-ennanced ultrasound(CEUS)of liver cirrhosis with small hepatocellular carcinoma(SHCC),and to analyze the efficiency of differential diagnosis of that for SHCC and dysplasia nodules(DN).Methods:78 patients with liver cirrhosis who admitted to hospital and underwent GEUS examination were selected,and the patients who were liver cirrhosis with SHCC were divided into SHCC group(55 cases with 62 lesions)and patients with DN lesions were divided into DN group(23 cases with 32 lesions).The enhanced mode,perfusion mode and the parameters of time-intensity curve(TIC)of each phase of CEUS of two groups were observed and compared.Results:The most of SHCC arterial phase was high enhancement,while that of DN was low enhancement.The differences of enhanced levels of arterial phase,portal vein phase and delayed phase of lesions between SHCC group and DN group were significant(χ^(2);-=69.124,χ^(2)=8.993,χ^(2)=52.392,χ^(2);=32.566,χ^(2)=32.566,χ^(2);=34.873,χ^(2)=34.873,P<0.05),respectively.The high-low-low was the main mode of perfusion mode of SHCC lesion,while the perfusion mode of DN lesion was complex and diverse,and the difference of the perfusion mode between two groups was significant(Z=70.450,P<0.05).The TIC of SHCC lesions was mainly"fast-up and fast-down",while that of DN lesions was mainly"slow-up and slow-down".The peak time,half time of descending and continuous enhancement time of SHCC group were significantly lower than those of DN group(t=5.349,t=7.020,t=25.966,P<0.05),respectively.Conclusion:SHCC has typical CEUS image features,and the combination of that with enhancement mode of three-stage and TIC parameters can provide a basis for early differential diagnosis of SHCC and DN on the basis of liver cirrhosis.
作者
姜智明
添林燕
卲菊
钱美娟
JIANG Zhi-ming;TIAN Lin-yan;SHAO Ju(Department of Ultrasound,The Sixth Nantong People's Hospital of Nantong,Nantong 226000,China;不详)
出处
《中国医学装备》
2022年第6期88-93,共6页
China Medical Equipment
基金
江苏省重点研究和开发计划(202003AK-581)“超声引导下肝癌肿瘤内注射抗肿瘤免疫效应细胞的临床研究”。
