动态三维超声造影对肝细胞癌的超声诊断价值

【目的】探讨动态三维超声造影（3D‐CEUS）对肝细胞癌的诊断价值。【方法】回顾性分析2014年6月至2015年12月本院收治的50例肝细胞癌患者临床和影像学资料。每例患者都进行动态3D‐CEUS 和增强 CT （CECT ）检查。对两种检查方法图像质量，包括动脉期肿瘤内部显示情况（增强方式、肿瘤内部血管）、各期肿瘤供血血管及肿瘤边界显示情况进行综合评分。【结果】注射造影剂后，50例肿瘤3D‐CEUS 显示均有不同程度的强化。评分结果表明：3D‐CEUS 为0分者3例，1分者10例，2分者37例；CECT 无0分者，1分者9例，2分者41例。对两种方法评分均为2分的32例肿瘤内部显示情况进一步分析发现，增强方式上3D‐CEUS 与 CECT 图像上无统计学差别（ P ＞0．05），一致性评分 Kappa 值为0．88。而在肿瘤内血管显示情况方面，3D‐CEUS 优于 CECT（ P ＜0．05）；在供血动脉方面，二者并不完全相同，0分和1分的图像3D‐CEUS与 CECT 无统计学差异（ P ＞0．05），而2分的图像3D‐CEUS 优于 CECT （ P ＜0．05）；在周边组织关系方面，二者无统计学差异（ P ＞0．05）。【结论】动态3D‐CEUS 对肝细胞癌的成像具有较高质量，在显示肿瘤增强方式、肿瘤边界的清晰度方面与 CECT 相同，而在显示肿瘤内部血管及供血血管方面，其能力优于 CECT 。

Evaluation of the Imaging Quality of Dynamic Three-Dimensional Contrast-Enhanced Ultra-sonography in the Diagnosis of Hepatocellular Carcinoma

Objective]To investigate the value of dynamic three‐dimensional contrast‐enhanced ultrasonography (3D‐CEUS) in the diagnosis of hepatocellular carcinoma .Methods]Clinical and imaging data of 50 patients with hep‐atocellular carcinoma admitted in our hospital from June 2014 to December 2015 were retrospectively analyzed .Each patient underwent 3D‐CEUS and contrast‐enhanced computed tomography (CECT ) .The image quality of the two methods ,including the internal display of the arterial phase (enhancement mode ,the internal blood vessels of the tumor) ,the blood vessels of the tumor vessels ,and the display of the tumor boundary were comprehensively scored .Results] After the injection of the contrast agent ,50 cases of tumor 3D‐CEUS were given different degrees of en‐hancement .The results showed that :According to 3D‐CEUS ,3 cases received scores of 0 ,10 cases received scores of 1 ,and 37 cases received scores of 2 while according to CECT ,no cases received scores of 0 ,9 cases received scores of 1 ,and 41 cases received scores of 2 .Further analysis of internal display of tumor of the 32 cases of patients receiving an average score of 2 using the two methods showed that there was no statistical difference between the 3D‐CEUS and CECT images in the enhancement mode ( P > 0 .05) ;the Kappa value of the consistency score was 0 .88 .In the as‐pect of blood vessels in the tumor ,3D‐CEUS was superior to CECT (P < 0 .05) .In the aspect of arteries ,the two methods were not completely consistent .Images with scores of 0 and 1 showed no statistically significant difference between 3D‐CEUS and CECT (P > 0 .05) ,while for images with scores of 2 ,3D‐CEUS was superior to CECT ( P< 0 .05) .In the aspect of relationship between peripheral tissues ,the two methods showed no significant difference (P > 0 .05) .Conclusion]Dynamic 3D‐CEUS had high imaging quality in hepatocellular carcinoma diagnosis ,and shows the enhancement way and boundary of hepatocellular carcinoma clearly as well as CECT does .In addition ,the ability of 3D‐CEUS in displaying tumor internal vessels and supplying vessels was superior to that of CECT .