小肝癌彩色多普勒血流图像及术中B超诊断

本文报道应用彩色多普勒血流图像（CDFI）及术中B超（IOUS）诊断小肝癌9例，显示小肝癌的肿瘤内外动脉血流图像占88．8％（8／9），动脉阻力指数（ARI）均＞60％（范围68％－89％），网篮征55．5％（5／9）。其它小 占位性病变（血管瘤，炎性假瘤，脂肪瘤，肝囊肿，肝结核），CDFI，ARI＞60及网篮征检出率明显低于小肝癌（P＜0．01）。具有鉴别诊断意义，本组CDFI对小肝癌诊断率为88．8％（8／9），1例漏诊，由IOUS诊断，肿瘤为位于右叶后方上段，＜2.0cm的病例。CDFI具有无创性，操作简便，血流图像检出率高等特点，从而进一步提高超声诊断的特异性。IOUS可进一步辅助CDFI诊断的不足，特别是对AFP阴性，瘤体位于盲区的小肝癌。

Evaluation of Color Doppler Flow Imaging and Intraoperative Ultrasound in Small Hepatocellular Carcinoma

Nine patients with small hepatocellular carcinoma(SHCC)and 15 patients with other hepatic occupied lesions were studied with color Doppler flow imaging(CDFI) and intraoperative ultrasound from December 1990 to Janurary 1994 in our hospital. The arterial flow within tumor as well as arterial flow entering tumor from its peripheral were the main feature of SHCC.The arterial resistent index per centage (ARI%)in SHCC was more higher and ranged from 68%to 89%in the series. Statistically, there were significant between the detection rates of SHCC and other hepatic occupied lesions(P<0.01).CDFI is a noninvasive,convenient and sensitive method for SHCC diagnosis. One patient with SHCC lesion smaller than 2.0cm, located at right upper persition of the liver near to the dome of diaphragm,was not detected by CDFI, but discovered by intraoperative ultrasound.The specificity of ultrasounic diagnosis will improved because CDFI may provide biood flow information of hepatic tumors.