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超声造影检测和诊断小肝癌的价值
引用本文:丁红,王文平,黄备建,李超伦,张晖,魏瑞雪.超声造影检测和诊断小肝癌的价值[J].中国普外基础与临床杂志,2007,14(1):28-31.
作者姓名:丁红  王文平  黄备建  李超伦  张晖  魏瑞雪
作者单位:复旦大学附属中山医院超声科,上海,200032
摘    要:目的探讨实时超声造影检测和诊断体积较小原发性肝癌的价值。方法分析353例共378个经临床和病理检查证实的直径≤3cm的原发性肝癌的超声造影表现,包括造影的增强时相和增强方式,并与病理类型相比较。结果所有原发性肝癌中96.6%(365/378)的病灶动脉相显示增强,其中317(83.9%)个病灶增强早于肝实质,48(12.7%)个病灶增强与肝实质同步;增强方式中329(87.0%)个病灶呈整体增强,35(9.3%)个呈斑片状增强,14(3.7%)个病灶呈环状增强。在门脉相和晚期相,342(90.5%)个病灶相对于肝实质呈低回声。若将造影时病灶动脉相增强早于或同步于肝实质以及门脉期消退作为超声造影诊断肝癌的标准,则敏感性为87.3%(330/378);若将整体增强和斑片状增强作为原发性肝癌的特异增强方式,结合增强方式和时相,则超声造影鉴别诊断原发性肝癌的敏感性为92.9%(351/378)。结论超声造影可实时动态观察肝肿瘤相对于肝实质的灌注和廓清过程,揭示肿瘤的血流动力学,在鉴别诊断小肝癌中具有重要的临床实用价值。

关 键 词:超声  造影剂  小肝癌  影像诊断
文章编号:1007-9424(2007)01-0028-04
收稿时间:2006-10-12
修稿时间:2006-10-30

Role of Contrast-Enhanced Ultrasonography in The Detection and Diagnosis of Small Primary Liver Cancer
DING Hong,WANG Wen-ping,HUANG Bei-jian,LI Chao-lun,ZHANG Hui,WEI Rui-xue.Role of Contrast-Enhanced Ultrasonography in The Detection and Diagnosis of Small Primary Liver Cancer[J].Chinese Journal of Bases and Clinics In General Surgery,2007,14(1):28-31.
Authors:DING Hong  WANG Wen-ping  HUANG Bei-jian  LI Chao-lun  ZHANG Hui  WEI Rui-xue
Institution:Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Abstract:Objective To investigate the value of contrast-enhanced ultrasonography in detection and diagnosis of small primary liver cancer. Methods SonoVue-enhanced ultrasonography were performed on 353 patients with 378 primary liver cancer, less than 3 cm in diameter. Enhancement patterns and enhancement phases of hepatic lesions on contrast-enhanced ultrasonography were analyzed and compared with the results of histopathology. Results In all hepatic tumors, 96.6% (365/378) lesions enhanced in the arterial phase. Among them, 317 (83.9%) tumors enhanced earlier than liver parenchyma and 48 (12.7%) tumors enhanced synchronously with liver parenchyma, and 342 (90.5%) tumors showed early wash-out in the portal and late phases. With regard to the enhancement pattern, 329 (87.0%) tumors presented whole-lesion enhancement, 35 (9.3%) to be mosaic enhancement and 14 (3.7%) to be rim-like enhancement. If taking the whole-lesion enhancement and mosaic enhancement in arterial phase as diagnotic standard for primary liver cancer on contrast-enhanced ultrasonography, the sensitivity was 92.9%(351/378), and if the earlier or synchronous enhancement of the tumor compared with liver parenchyma in arterial phase and the wash-out in portal phase were regarded as the stardand, the sensitivity was 87.3%(330/378). Conclusion Contrast-enhanced ultrasonography could display real-time enhancement patterns as well as the wash-out processes both in hepatic tumors and the liver parenchyma. It might be of clinical value in diagnosis of primary liver cancer based on the hemodynamics of hepatic tumors on contrast-enhanced ultrasonography.
Keywords:Ultrasonography Contrast media Small primary liver cancer Imaging diagnosis
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