超声在诊断转移性肝癌中的价值

Diagnostic value of ultrasound to liver metastasis

目的 探讨超声对转移性肝癌的诊断价值和转移性肿块声像图特征。方法 常规对我院住院的178例转移性肝癌进行检查。结果 超声检出肝内转移性病灶174例，其中肝左叶16例，右叶64例，肝双叶94例。共检出肿块669个。转移性肝癌以侵犯肝双叶并以多个结节存在为多。超声可检出〈1cm大小的结节，但以1～4．9cm的肿块为多，共140例，占80．46％（140/174）。肿块回声特征与原发性肿瘤病种有关，呈多样性，但以低回声型为多，占112例，达64．37％（112／174）。对转移性肝癌超声检出率为97．75％（174／178）。超声与CT、MRI检查对比，显示CT、MRI检出率略高，可达到98．11%〈104／106）、98．61％（71／72），超声检出率较以上两项影像检查略低，但无统计学差异（P〉0．05）。结论 超声检查对转移性肝癌诊断准确性较高，具有重要的实用价值，可作为首选的检查方法。

Objective To study the diagnostic value of ultrasound to liver metastasis and the imaging characteristics of metastasis masses. Methods Ultrasonographic examinations with 3.75 MHZ detector were performed on 178 patients with liver metsstasis. The results were compared to that underwent computer tomography （CT） or magnetic resonance imaging （MRI）. Results Ultrasound found 174 cases with liver metastasis and 669 masses. There were 16 cases in left hepatic lobe, 64 cases in right hepatic lobe, 94 cases in both hepatic lobes, respectively. Most of the masses invaded both hepatic lobes and manifested with multiple masses. Ultrasound could show mass which was smaller than 1 cm. The size of masses in most cases（ 140/174, 80.46% ） were 1 ～ 4.9 cm. The ultrasonographic characteristics were related wieh primary carcinoma and diversified. Most masses（ 112/174, 64.37%） showed low level echo. The sensitivity of high- frequency ultrasound was 97.75% （174/178） and slightly lower than CT （104/106,98.11%） and MRI （71/72,98.61% ）. The differences were not significant （ P 〉 0.05）. Conclusion Ultrasonography has high diagnostic value to liver metastasis and important practical significance. Ultrasonography can be the first- line approach to diagnose liver metastasis.