超声造影在肝硬化再生结节与肝细胞性肝癌鉴别诊断中的应用

目的探讨超声造影（CEUS）在肝细胞性肝癌（HCC）与肝硬化再生结节诊断和鉴别诊断中的应用价值。方法对46例肝硬化背景的58个局灶性病变进行超声造影检查并观察其动脉相、门脉相和实质相的动态造影变化,对不同性质病变的造影特点进行分析总结,并与穿刺病理诊断结果进行比较。结果肝细胞性肝癌患者中92.86%（13/14）的病灶具有造影剂的快进快出及85.71%（12/14）的病灶具有动脉相均匀性或非均匀性充填整个肿块的特点,超声造影剂在肝细胞性肝癌中的快进快出即动脉相快速增强,门脉相和实质相快速消退。结论超声造影在肝硬化与肝细胞性肝癌肝脏内局灶性异常回声的检查及鉴别诊断中具有重要的临床意义和应用价值。

The role of contrast-enhanced ultrasound in the detection of hepatocellular cancer and the nodus of liver cirrhosis

Objective To assess the value of contrast-enhanced ultrasound (CEUS)in the diagnosis of hepatocellular cancer (HCC)and the nodus of liver cirrhosis.Method Dynamic changes in different phases were studied during the contrast-enhanced ultrasonic examination in 46 cases.All the cases were confirmed by liver biopsy.Results 92.86% of HCC were characterized by quick wash-in and wash-out (high and rapid peak of enhancement in the arterial phase,followed by a relative quick wash-out in the portal phase1) and 85.71% of HCC were homogeneous or inhomogeneous enhancement with CEUS(chaotic peri-tumoral and intra-lesional tortuous vessels and irregular vascular lakes).Conclusion CEUS in the diagnosis of HCC and nodus of liver cirrhosis is of high clinical significance and value.