肝细胞性肝癌超声造影表现与肿瘤病理分化关系的研究

目的探讨肝细胞性肝癌（HCC）超声造影（CEUS）表现与肿瘤病理分化的关系。方法121个HCC病灶接受了CEUS和病理学检查。CEUS使用造影剂声诺维和对比脉冲序列（CPS）成像技术，组织病理诊断按Edmonson法分类。结果肿瘤分化程度与肿瘤增强变低时间呈线性相关。不同分化程度的肿瘤增强变低的时间及延迟期肿瘤的增强水平均有明显差异（P=0．04、P=0．026），但肿瘤开始增强时间、增强变等时间以及动脉期和门脉期肿瘤的增强水平无明显差异（P=0．26、P=0．33、P=0．23、P=0．58）。结论在CEUS上HCC增强消退的时间与肿瘤分化程度相关。分化好的HCC病灶增强减退较慢，少数病灶门脉期或延迟期仍可呈等或高增强，分化差的肿瘤增强减退较快，绝大多数病灶门脉期或延迟期呈低增强。

Evaluation of Hepatocellular Carcinoma Using Contrast-enhanced Ultrasound: Correlation with Tumor Differentiation

Objective To evaluate the relationship between enhancement pattern of hepatocellular carcinoma(HCC) and tumor differentiation by using contrast-enhanced ultrasound(CEUS).Methods One hundred and twenty-one HCC lesions underwent examination of CEUS and pathology.CEUS was performed with SonoVue and contrast pulsed sequencing(CPS).Pathological diagnoses were made according to Edmonson criteria.Results The time of HCC become hypo-enhancing was linearly correlated with tumor differentiation.Significant differences were shown between the time of HCC become hypo-enhancing or echogenics in late phase and tumor differentiation(P=0.04;P=0.026 respectively),but not with the time of initial hyper-enhancing or iso-enhancing or echogenics in arterial phase and portal phase(P=0.26,P=0.33;P=0.23,P=0.58 respectively).Conclusions There is relationship between the time of HCC becoming hypo-enhancing and tumor differentiation.Well differentiated tumors washout more slowly than poor differentiated ones.