超声显示结节性肝癌肝动脉窃血现象及其临床意义

"The appearance of pilfering blood" of hepatic artery showed in patients with nodular hepatic carcinoma by ultrasonography and its clinical significance

目的探讨结节性肝癌(肿块的直径在1cm左右)无创性早期诊断的方法。方法随机选取结节性肝癌和结节性肝硬化患者、正常对照者共3组各90例,应用超声检查各自的肝动脉、肠系膜上动脉的血流量(V)、收缩期峰速度(Vp)、阻力指数(RI),并对上述参数进行组间和组内统计学分析。结果结节性肝癌患者肝动脉的V和Vp明显高于肠系膜上动脉(P<0.05)、RI低于肠系膜上动脉(P<0.05);结节性肝硬化患者肝动脉V和Vp明显低于肠系膜上动脉(P<0.05)、RI高于肠系膜上动脉(P<0.05);正常对照者肝动脉的V和RI稍低于高于肠系膜上动脉、Vp稍高于肠系膜上动脉,但均无统计学意义(P>0.05);结节性肝癌患者肝动脉的V明显高于结节性肝硬化患者和正常对照者肝动脉的V(P>0.05)。结论肝动脉V和Vp高于肠系膜上动脉、而RI降低(即肝动脉“窃血现象”)可作为早期诊断结节性肝癌的指标。

Objective To seek method of diagnosing nodular hepatic carcinoma (the diameter of tumour is around 1cm) early stage with non-invasive examining. Methods The patients with nodular hepatic carcinoma or nodular hepatocirrhosis and normal persons randomly chosen, and each groups, 90 cases;the volume of blood flow(V), the systolic peak value velocity(Vp), the resistance index (RI) of hepatic artery and superior mesenteric artery in two groups patients or normal subjects were detected with ultrasono-graphic examining. Results The V and Vp of hepatic artery were higher and its RI was lower than one of superior mesenteric artery in the patients with nodular hepatic carcinoma (P<0.05). The V and Vp of hepatic artery was lower and its RI was higher than ones of superior mesenteric artery in patients with nodular hepatocirrhosis (P<0.05). The V and RI of hepatic artery was little lower and its Vp was little higher than ones of superior mesenteric artery but the difference of V or Vp or RI between hepatic artery and superior mesenteric artery was not statistic significance in the normal persons(P>0.05). The V of hepatic artery in patients with nodular hepatic carcinoma was higher than one of superior mesenteric artery in patients with nodular hepatocirrhosis or the normal persons(P>0.05). Conclusion It is the criteria of diagnosing the disease of nodular hepatic carcinoma early stage that the V and Vp of hepatic artery is higher and its RI is lower than ones of superior mesenteric artery ('The appearance of grabbing the blood' of hepatic artery) in the persons.