彩色多普勒能量图对小肝癌与肝腺瘤样增生结节的鉴别诊断研究

目的　探讨彩色多普勒能量图 (CDE)对小肝癌与肝腺瘤样增生结节的鉴别诊断价值。方法　对2 1例小肝癌和 8例肝腺瘤样增生结节进行了CDE检查 ,并与数字减影血管造影 (DSA )对照。结果　小肝癌动脉肿瘤输入血管检出率 85 .7% ,门静脉肿瘤输入血管检出率 42 .9% ;肝腺瘤样增生结节门静脉肿瘤输入血管检出率 62 .5 % ,无一例存在动脉肿瘤输入血管 ,两组相比差异有非常显著性意义 (P <0 .0 1)。此外CDE可显示11例 (5 2 .4% )小肝癌有肿瘤输出静脉血管 ,其中 10例 (4 7.6% )为门静脉肿瘤输出血管 ,1例为肝静脉肿瘤输出血管 ,而肝腺瘤样增生结节无一例有肿瘤输出静脉血管 ,两组相比差异有非常显著性意义 (P <0 .0 1)。结论　彩色多普勒能量图对小肝癌与肝腺瘤样增生结节的鉴别诊断具有一定的意义 ,输入肿瘤的动脉血管和输出肿瘤的静脉血管可作为小肝癌区别于肝腺瘤样增生结节的主要鉴别点

The study of color Doppler energy in differential diagnosis of small hepatocellular carcinoma and adenomatous hyperplastic nodule

Objective To evaluate the application of color Doppler energy(CDE) in differential diagnosis of small hepatocellular carcinoma(SHCC) and adenomatous hyperplastic nodule(AHN).Methods Twenty one cases with SHCC and 9 cases with AHN were investigated by CDE and correlated with finding at digital subtraction angiography(DSA).Results The detecting rate of arterial flow afferent tumor vessel and portal flow afferent tumor vessel were 85.7% and 42.9% in SHCCs,respectively.The detecting rate of portal flow afferent tumor vessel was 55.6% in AHN,but no arterial flow was detected (P< 0.01 ).In addition,CDE revealed a constant flow efferent tumor vessel ( 52.4% )continuing to a portal branch in 10 ( 47.6% ) of the 21 HCC,to a hepatic vein in 1 (5%) of the 21 HCC,but in none of the AHN (P< 0.01 ).Conclusions Color Doppler energy is of value in distinguishing these two lesions,arterial afferent tumor vessel and constant flow efferent tumor vessel at CDE could be regarded as the differential diagnosis of SHCC differentiation from AHN.