原发性肝癌超声造影诊断的特征性声像图表现

目的探讨超声造影诊断原发性肝癌的特征性声像图表现。方法对经病理检查或穿刺活组织检查确诊的25例(30个病灶)原发性肝癌患者实施超声造影检查,观察患者病灶特征和声像图表现,并将诊断结果与常规超声诊断结果进行比较,判断两种诊断方式的敏感性。结果原发性肝癌的内部结节数目不多,多为单发,病灶与正常组织间界限清楚,边缘处较为整齐,回声除小部分不均匀外,其余皆比较均匀,其形状表现为圆形或类圆形。有19例患者诊断为肝细胞癌,声像图表现为"快进快出","快进快出"表现越为明显患者,其肿瘤分化程度也越低。有6例患者诊断为肝内胆管细胞癌,声像图主要表现为"快进快出",病灶图像在动脉期呈现为网格状增强,部分显示无增强;在门静脉期时,病灶周边环状不规则增高,病灶内部则表现为网格状增强或无增强;当处于门静脉期时,病灶周边环状不规则增强明显消退。超声造影诊断敏感度为96%,与常规超声的72%比较,存在明显差异(P0.05)。结论超声造影诊断原发性肝癌可以清楚的显示病灶图像特征,较常规超声诊断敏感性高。

Sonogram characteristics of ultrasound contrast in diagnosis of primary liver cancer

Objective To investigate the sonogram characteristics of ultrasound contrast in diagnosis of primary liver cancer .Methods Twenty‐five patients (30 lesions) histologically diagnosed as primary liver cancer in our hospital from March 2015 to March 2014 were enrolled in the study .Contrast‐enhanced ultrasound was performed in all those patients , which were compared with conventional ultrasound to evaluate sensitivity between the two diagnostic methods .Results The ultrasound in primary liver cancer manifested single ,round or ovoid shaped focal ,with majority of homogeneous echoes and minority of heterogeneous echoes ,and smooth and clear boundary to normal tissue .In these patients ,19/25 (76% ) were diagnosed of hepatocellular carcinoma with sonogram as fast‐coming and fast‐going ,which were negatively correlated with tumor differentiation .The 6/25 (24% ) patients were diagnosed of intrahepatic bile duct cell carcinoma with sonogram as fast‐coming and fast‐going .In arterial phase ,lesion images manifested as majority of grid‐like enhancements and minority of no enhancement .In portal venous phase ,peripheral of lesions were irregular ring‐enhanced ,and internal of lesions were grid‐like enhanced or with no enhancement .Additionally ,the irregular enhancement of lesions peripheral was significantly decreased during portal vein phase .The diagnostic sensitivity of contrast‐enhanced ultrasound for primary liver cancer was 96% (24/25) ,which was significantly higher than 72% (18/25) of conventional ultrasound (P<0 .05) .Conclusion The diagnosis of primary liver cancer by ultrasound contrast can clearly show the characteristics of lesion images ,which is more sensitive than conventional ultrasound .