肝移植术后肝癌复发的超声造影与CT诊断比较

目的探讨超声造影（CEUS）对肝移植术后肝癌复发的诊断价值。方法对肝癌病人肝移植术后常规彩色超声随访发现肝内占位性病变23例，先行超声造影检查，3d内行螺旋CT增强扫描，分别与病理结果比较。结果23例病人经过穿刺活检病理确诊20例，行再次肝移植术经病理确诊3例，CEUS确诊18例，疑诊4例，误诊1例；CT确诊20例，疑诊2例，误诊1例。结论CEUS与CT对原位肝移植术后肝癌复发的诊断均很敏感且价值很高，尤其对不典型病灶的诊断，CT与CEUS结合能提高诊断率。

Comparison of contrast-enhanced ultrasonography with CT in diagnosis of post-transplant recurrent liver carcinoma

Objective To explore the diagnostic value of contrast-enhanced ultrasonography(CEUS) in post-liver transplant recurrent hepatocellular carcinoma(HCC) after liver transplant.Methods Twenty-three patients with mass founded by color Doppler flow imaging(CDFI) were performed contrast-enhanced ultrasonography and contrast-enhanced helical CT sequentially in 3 days,then the imaging impressions were compared with the final pathologic diagnosis respectively,and the diagnostic value of CEUS was evaluated.Results Of these 23 patients,20 were confirmed diagnosis by needle biopsy and 3 were confirmed during the course of liver retransplantation alternatively;CEUS approach confirmly diagnosed 18 patients(78.26 %),doubted 4 patients(17.39 %),and misdiagnosed 1 patient(4.34 %);with CT approach confirmly diagnosed 20 patients(86.96 %),doubted 2 patients(8.70 %),and misdiagnosed 1 patients(4.34 %).There was no significance( P > 0.05) in diagnosis of HCC recurrence between CEUS and helical CT.Conclusion Both CEUS and helical CT are sensitive and accurate in diagnosis of recurrent HCC after liver transplantation.Combined CEUS with helical CT can improve the diagnostic accuracy of recurrent HCC with atypical lesions.