超声造影在肝细胞性肝癌术后查找隐匿性病灶中的应用价值

The contrast enhanced ultrasound for the dormant mass after hepatctom in hepatocellular carcinoma

目的探讨超声造影查找肝细胞肝癌(HCC)术后隐匿性病灶的应用价值。方法肝癌术后50～90d常规超声复查肝脏为阴性的87例患者中,42例临床症状或实验室检查疑似肿瘤复发,对疑似病例进行肝脏超声造影检查。超声造影检查发现可疑病灶经数字减影血管造影(DSA)或超声引导穿刺活检组织送病理检查。结果肝脏超声造影检查发现12例患者肝内14处隐匿性病灶,其中8个病灶经超声引导穿刺活检证实,另6个病灶经肝脏数字减影血管造影(DSA)检查证实并治疗后甲胎蛋白(AFP)降至正常。病灶直径0.7～3.2(平均1.21)cm。结论肝癌术后隐匿性病灶的早发现、早治疗,对延长肝癌术后患者生存期有相当积极的作用。肝脏超声造影检查是发现隐匿性病灶的敏感检测手段。

Objective To investigate the role of contrast enhanced ultrasound（CEUS）of finding the dormant mass for the hepatocellular carcinoma （HCC）after hepatectomy.Methods Among 87 patients with HCC receiving ultrasound examination patients in 50 - 90 day after operation, and 42 patients which were not detected by CEUS examination, According the clinical manifestation and laboratory examination of the 42 patients, they were suspect that HCC reccur. Results Fourteen latent lesions were detected by CEUS examination in 12 patients. The diameter of lesions is from 0.7 cm to 3.2 cm, and average 1.21 cm. 8 latent lesions were confirmed by liver biopsy. Six latent lesions were detected and treatment by digital substraction angiography （DSA）, and alpha- fetoprotein （AFP） values recovered to normal. Conclusion Early diagnosis and early therapy for latent hepatic tumor after operation play an active role in prolonging life of patients with HCC. CEUS was a positive and effective method to find latent HCC.