早期肝内小占位病变的二维超声形态特征及临床意义

The characteristics and clinical significance of two dimentional ultrasound in the diagnosis of small liver lesions

目的探讨肝内小占位病灶的灰阶形态特点以寻求实用且可行的早期诊断小肝癌的条件。方法经超声检查发现的肝内小的占位性病变(最大径线<3cm)患者60例,经手术病理证实或肝组织病理活检证实其中原发性小肝癌34例,海绵状血管瘤14例,肝内局灶性脂肪缺失6例,瘤样结节增生3例,炎性假瘤3例。并对其形态特征给予了对比分析。结果本研究中88%(30/34)的小肝癌以弱回声为主,其余12%(4/34)为稍强及强回声。癌性结节多为规则的正圆形或类圆形,大部分可见完整包膜或晕环,多可测得周边或中心性血流。在非癌性结节中强回声多见,少数为低回声,多为不规则型,少数为类圆形,无完整包膜或声晕,很少测及血流信号。结论依据病灶的二维形态特征可提高小肝癌的早期阳性发现率。

Objective Aim To find out a possible and practical method for the early diagnosis of small liver lesions by grey scale ultrasound. Methods Sixty cases of patients were found to have small liver lesions under scanning by ultrasound, while there were 34 cases proved as primary hepatical carcinoma, 14 cases as hemangioma, 6 cases as focal liver deficit, 3 cases as tumor like nodules. Their shape and charateristics under two dimentional ultrasound were compared and analyzed. Results We found 88 % of the small carcinoma lesions were hypoechoic, while the other cases were slightly hyperechoic or hyperechoic. Nodules of carcinoma were regularly round or oval shape, most of them could be found with a integument or a halo. And most of these lesions could be detect out centrical or peripheral blood flow signals. Among those benign lesions, most of them were hyperechoic with an irregular shape （ parts of them were hypoechoic with an oval shape）, no complete integument or halo, and blood signals could be found rarely. Conclusion Careful differentiation on the features of small liver lesions under two dimentional ultrasound were of helpful to the early diagnosis of small malignant liver lesions.