摘要
目的探讨术前彩色多普勒超声血流参数对原发性与转移性肝癌的鉴别诊断价值。方法选取107例肝癌患者,术前均接受超声检查,依据病理检查结果(原发性肝癌或转移性肝癌)分为原发组(n=59)和转移组(n=48),比较两组患者瘤内和瘤周血流信号检出情况,比较两组患者的血流参数;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估血流参数单独及联合检测对原发性肝癌与转移性肝癌的鉴别诊断价值。结果原发组患者瘤周和肿瘤内部血流信号检出率分别为93.22%、86.44%,均高于转移组患者的77.08%、66.67%,差异均有统计学意义(P﹤0.05)。原发组患者肝动脉峰值流速、肝动脉血管内径、肝动脉阻力指数均明显高于转移组,门静脉血流流速明显低于转移组,差异均有统计学意义(P﹤0.01)。肝动脉峰值流速、肝动脉血管内径、肝动脉阻力指数及门静脉血流流速联合检测诊断转移性肝癌的AUC为0.939(95%CI:0.875~0.976),均高于各指标单项检测(P﹤0.05),各指标诊断转移性肝癌的最佳截断值分别为94.900 cm/s、5.190 mm、0.730、14.860 cm/s。结论术前彩色多普勒超声检查能准确反映肝癌的血供分布情况,其血流参数变化对临床鉴别原发性肝癌与转移性肝癌具有较高的价值。
Objective To investigate the value of preoperative color Doppler ultrasound blood flow parameters in the differential diagnosis of primary and metastatic liver cancer.Method A total of 107 patients with liver cancer were selected.All patients received ultrasound examination before the operation,and were divided into the primary group(n=59)and the metastatic group(n=48)according to the results of pathological examination(primary liver cancer or metastatic liver cancer).The intratumoral and peritumoral blood flow signal detection were compared between the two groups.And the blood flow parameters were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the value of blood flow parameters alone and in combination in the differential diagnosis of primary liver cancer and metastatic liver cancer.Result The detection rates of peritumoral and intratumoral blood flow signals in the primary group were 93.22%and 86.44%,respectively,which were higher than 77.08%and 66.67%in the metastatic group,and the differences were statistically significant(P<0.05).The peak hepatic artery flow velocity,hepatic artery inner diameter,and hepatic artery resistance index in the primary group were significantly higher than those in the metastatic group,and the portal vein blood flow velocity was significantly lower than that in the metastatic group,and the differences were statistically significant(P<0.01).The combined detection of peak hepatic artery flow velocity,hepatic artery inner diameter,hepatic artery resistance index,and portal vein blood flow velocity for the diagnosis of metastatic liver cancer had an AUC of 0.939(95%CI:0.875-0.976),which was higher than the single detection of each index(P<0.05).The cut-off values of each index for the diagnosis of metastatic liver cancer were 94.900 cm/s,5.190 mm,0.730 and 14.860 cm/s,respectively.Conclusion Preoperative color Doppler ultrasonography could reflect the blood supply distribution of live
作者
郑蕊
李秀芹
代笑梅
ZHENG Rui;LI Xiuqin;DAI Xiaomei(Department of Ultrasound,Affiliated Hospital of He’nan Academy of Chinese Medicine,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2022年第18期1926-1929,共4页
Oncology Progress
关键词
原发性肝癌
转移性肝癌
彩色多普勒超声
血流参数
诊断价值
primary liver cancer
metastatic liver cancer
color Doppler ultrasound
blood flow parameter
diagnostic value
