超声造影在肝细胞癌与肝局灶性结节增生鉴别中的价值研究

目的 探讨超声造影在肝细胞癌(HCC)与肝局灶性结节增生(FNH)鉴别中的价值.方法 回顾性分析本院于2014年2月至2016年3月收治的37例HCC患者和35例FNH患者,根据病情不同将患者分为HCC组和FNH组,术前所有患者均进行超声造影检查,记录患者的血流灌注参数,计算增强时间和增强斜率.比较两组患者的超声造影结果与病理检验结果或手术结果,比较两组患者超声造影的符合率、灵敏度和特异度.结果 HCC组的超声造影剂的到达时间(AT)、达峰时间(TTP)和增强时间分别为(12.8±2.1)s、(21.4±3.8)s、(9.1±1.9)s,均较FNH组的(10.2±1.2)s、(16.6±2.7)s、(6.2±1.8)s延迟(P＜0.05);HCC组增强斜率为(3.4±1.0) dB/s,较FNH组[(5.3±1.6) dB/s]小(P＜0.05);而两组患者的峰值强度和符合率、灵敏度、特异度之间比较差异无统计学意义(P＞0.05).结论 HCC和FNH的超声造影血管灌注参数区别较明显,且超声造影在诊断HCC和FNH中的符合率和灵敏度较高,均具有重要的临床应用价值.

Identification value of ultrasound contrast in hepatocellular carcinoma and hepatic focal nodular hyperplasia

Objective To investigate the value of ultrasound contrast in the differential diagnosis of hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH).Methods 37 cases of HCC and 35 cases of hepatic FNH in our hospital from February 2014 to February 2016 were retrospectively analyzed.All patients underwent ultrasound contrast examination before operation.The blood perfusion parameters were recorded,the enhancement time and enhancement slope were calculated.The ultrasound contrast result was compared with pathological results or operative results,compared the coincidence,sensitivity and specificity of two groups.Results The arrival time (AT),time to peak (TTP),and enhancement time of ultrasound contrast in HCC group were (12.8±2.1)s,(21.4±3.8)s,(9.1±1.9)s,those in FNH group were (10.2±1.2)s,(16.6±2.7) s,(6.2±1.8)s,those in HCC group were longer (P＜0.05).The enhancement slope in HCC group was (3.4±1.0) dB/s,that in FNH group was (5.3±l.6)dB/s,that in HCC group was lower (P＜0.05).There were no statistically significant differences in peak intensity,the coincidence,sensitivity,and specificity between two groups (P＞0.05).Conclusions The blood perfusion parameters between two groups have significant difference,and there are high coincidence,specificity on ultrasound contrast between two groups,both of them have important application value in clinic.