29例肝癌的超声检查与增强CT的对比分析

The comparative analysis of 29 hepatocellular carcinoma cases by ultrasonography and enhanced CT.

目的用增强CT作为相对金指标,对29例肝癌的超声检查进行一一对比分析总结,从而提高超声的检查质量和水平。方法收集29例肝癌患者均做超声和增强CT检查,先对增强CT重新进行了观察,排除假阳性征象的可能,再以其作为相对金指标,对比分析和总结。结果超声3例漏诊;病变的部位、形态、大小显示符合率分别为71%(25/29)、76.%(22/29)和72%(21/29);病变显示超声以弱回声、CT以低密度为主;超声检出门静脉癌栓形成14例,腹水征17例;CT检出门静脉癌栓15例,下腔静脉癌栓2例,腹腔大血管旁淋巴结显示、肿大3例,腹水征16例。本组患者均为男性,且有慢性肝病史,其中肝硬化22例。结论利用增强CT的相对优势,对肝癌的超声诊断进行一一对比分析和总结,有利于提高超声诊断水平。

Objective To improve the quality and level of ultrasonography based upon a comparative analysis of 29 cases of hepatocellular carcinoma by ultrasonography and enhanced CT which acts as a relative gold standard.Methods The 29 cases of hepatocellular carcinoma were checked by ultrasonography and enhanced CT.Enhanced-CT results were analyzed firstly so as to rule out the possibility of false-positive signs.Secondly,analysis and summary were made by comparing the ultrasound-results with CT-results,the relative gold standard.Results Three cases of ultrasonic misdiagnosis;accordance rates in respect of lesion location,shape,and size were 71%（25/29）,76%（22/29） and 72%（21/29） respectively;Lesions showed the weak echo ultrasound and low-density CT.Portal vein tumor thrombus was detected in 14 cases and ascites were detected in 17 cases by Ultrasound.Portal vein tumor thrombus was detected in 15 cases and inferior vena cava tumor thrombus was detected in 2 cases by CT.Enlargement of abdominal lymph node beside blood vessels emerges in 3 cases.Ascites were detected in 16 cases.The patients in these cases were male who suffer chronic liver disease and include 22 cases of cirrhosis of the liver.Conclusion By taking the relative advantages of enhanced CT for diagnosis of hepatocellular carcinoma,comparative analysis between ultrasound and enhanced CT can improve the level of ultrasound diagnosis.