超声造影对肝癌诊断及TACE治疗后残癌评价研究

目的探究超声造影对肝癌的诊断价值以及经导管肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）治疗后的残癌评定价值。 方法选取疑似原发性肝癌患者76例作为研究对象，对所有疑似患者进行数字减影血管造影（digital subtraction angiography，DSA）检查和临床诊断确诊。以DSA检查为金标准，观察常规超声检查和超声造影诊断肝癌的敏感度和特异度，并分析其术后残癌评价。 结果本研究所纳入64例单个病灶和5例无肝癌病灶患者中，常规超声检查中肝癌病灶阳性50例，阴性2例；超声造影阳性61例，阴性5例，超声造影诊断的敏感度、特异度以及诊断符合率均显著高于常规超声，差异有统计学意义（P＜0.05）。TACE术后58例病灶存在残留活性迹象，6例病灶完全失活，其中常规超声检查中肝癌病灶阳性44例，阴性1例；超声造影阳性55例，阴性4例，超声造影诊断的敏感度、特异度以及诊断符合率均显著高于常规超声，差异有统计学意义（P＜0.05）。 结论采用超声造影检查原发性肝癌可以提高病灶诊断符合率，改善TACE术后残癌检测质量，值得在相关临床诊断和术后评估中推广使用。

Contrast-enhanced ultrasonography in the diagnosis of liver cancer and the evaluation of residual cancer after TACE

ObjectiveTo explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in liver cancer and the evaluation value of residual cancer after TACE treatment.MethodsA total of 76 patients with suspected primary liver cancer were selected as study subjects for digital subtraction angiography(DSA) examination and clinical diagnosis. The sensitivity and specificity of routine ultrasound and CEUS in the diagnosis of liver cancer were observed with DSA as the gold standard, and their postoperative residual cancer evaluation was analyzed.ResultsIn this study, 64 patients with single lesions and 5 patients with no liver cancer lesions were included; 50 cases were positive and 2 cases were negative in routine ultrasound examination, while 61 cases were positive and 5 cases were negative in CEUS. The sensitivity, specificity and diagnostic coincidence rate of CEUS diagnosis were significantly higher than those of routine ultrasound(P＜0.05). There were 58 signs of residual activity after TACE operation, 6 cases of complete inactivated. Among them, 44 liver cancer lesions were positive and 1 case was negative in routine ultrasound examination; 55 liver cancer lesions were positive and 4 cases were negative in CEUS. The sensitivity, specificity and diagnostic coincidence rateof CEUS were significantly higher than those of routine ultrasound(P＜0.05).ConclusionCEUS for primary liver cancer can improve the diagnostic coincidence rate of lesions and improve the quality of residual cancer detection after TACE operation, which is therefore worthy of popularization in relevant clinical diagnosis and postoperative evaluation.