彩色多普勒超声在肝细胞癌与胆管细胞癌鉴别诊断中的价值

目的　探讨彩色多普勒超声在肝细胞癌与胆管细胞癌鉴别诊断中的价值。方法　对 30 例肝细胞癌与28例胆管细胞癌侵犯门静脉的彩色多普勒超声表现进行对比分析。结果　30例肝细胞癌发生门静脉瘤栓56条,受侵血管壁全部显像清晰,管腔内见瘤栓实体(100%);28 例胆管细胞癌侵犯门静脉 29 条,其中仅 6.9%(2/29)血管壁显像清晰。肝细胞癌组门静脉瘤栓内 75.0%(42/56)测及动静脉血流,60.7%(34/56)测及高速动脉血流;胆管细胞癌组受侵门静脉内仅 13.8%(4/29)测及血流信号。肝细胞癌组与胆管细胞癌组受侵门静脉周边测及高速动脉血流者分别占 80.4%(45/56)与 31.0%(9/29)。以上结果均有非常显著性意义(P<0.01)。结论　彩色多普勒超声在肝细胞癌与胆管细胞癌的鉴别诊断中具有重要的临床意义。

Value of color Doppler in differential diagnosis of hepatocellular carcinoma and cholangiocarcinoma

Objective To probe the value of color Doppler ultrasound in the differential diagnosis of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC).Methods The color Doppler images of 30 cases of HCC and 28 cases of CC which all had invasions of the portal veins were compared.Results Fifty-six portal veins were invaded in 30 cases of HCC.The walls of the invaded vessels were clearly showed.The tumor cell embolus could be seen in the vessels (100%).Twenty-nine portal veins were invaded in 28 cases of CC of which only 6.9% (2/29 veins) could show the walls of the vessels.The flow of the artery and vein could be detected by color Doppler in 75.0%(42/56 veins) of the tumor cell embolus of the portal veins in HCC with 60.7%(34/56 veins)showing high speed artery flow.On the contrary,the color Doppler flow could be detected in only 13.8%(4/29 veins) of the invaded portal veins of CC.The high speed artery flow was detected beside the invaded portal veins in 80.4% (45/56 veins) of HCC which was markedly higher than 31.0% (9/29 veins) of CC.All the parameters above of the two groups were markedly different (P< 0.01).Conclusions The color Doppler is of significance in differential diagnosis of HCC and CC in clinic.