539例转移性肝癌的声像图分析

TX Analysis of Ultrasonography of 539 Cases in Metastatic Hepatic Carcinoma

目的：分析转移性肝癌的声像图，以证实不同组织器官来源的转移性肝癌的声像图可有不同的特征。材料及方法：上海医科大学肿瘤医院住院及门诊转移性肝癌５３９例。采用ＡｌｏｋａＳＳＤ－６５０型及ＤｉａｓｏｎｉｃｓｓｐｅｃｔｒａＶＳＴ彩色超声显像仪从不同切面扫查肝脏。结果：肝转移性肿瘤涉及的器官及组织多达２２种，肠癌的肝转移率最高达２８％；其次是胃癌、鼻咽癌、乳腺癌及肺癌、食道癌（分别为１５％、１２６％、１２４％，９６％及５６％）。不同组织器官来源的肝转移灶可有不同的声像图表现。（１）胃肠道肝转移灶可伴有声晕。大肠癌肝转移灶高回声比例（５８％）大于其它肿瘤，转移灶具有肿块较大，伴液化坏死较明显的特征。（２）乳腺癌、胃癌、食道癌、肺癌的肝转移灶较小，低回声明显多于高回声（分别为７３％、５３％、４３％、４２％）。（３）肺癌、胃癌、乳腺癌“牛眼征”发生率较其它癌高（１８％～４４％）。（４）恶性淋巴瘤及鼻咽癌的肝转移灶呈较均质的低回声，低回声率高达７７５％，且不伴声晕。结论：转移性肝癌的声像图特征对临床查找原发癌有一定的帮助。

PURPOSE:To analyze the sonography of metastatic hepatic cancer (MHC)so as to proved that unlike tissue-organic sources of MHC had unlike sonographic feature.MATERIAL and METHOOS:539 cases of MHC of hospitazed and outpatients in Tumor Hospital of Shanghai Medical University.All ultrasonography examination were performed by color ultrasonography it was scan various plane in liver.RESULTS:MHC were invoved kind of tissue-organs more than 22. Metastatic rate of large intestinal cancer was as high as 28%,secondary gastric cancer,then nosopharyngeal cancer,breast cancer,lung cancer,esophageal cancer etc.(15%,126%,124%,96%,56%respectivelly)MHC of different tissue-organs may had various sonographic features:(1) Hyperechoic rate(55%)of MHC of large intestinal cancer was higher than other cancer because of it was inclued large mass and accompanied by necrosis of liquefaction This is a clear feature.General,hepatic metastatic focus(HMF)of gastroenteric cancer may be associated with hypoechoic ring.(2) Breast cancer,gastric cancer,esophageal cancer and lung cancer,usually occur small metastatic foci in liver may results in much more hypoechoes than hyperechoes.(73%,53%,43%,42%respectivelly)(3)Lung cancer,gastric cancer and breast cancer to have'buphthalmas signs'it was frequency higher than other cancer.(4)HMF of maliglant lymphoma and nosopharyngeal cancer were homogeneous hypoechoes and hypoechoic rate rise to 771% but no association with echoic ring.Conclusion:Features of sonography of MHC were may helpful try to find primary carcinoma.