复发性与初发性肝细胞肝癌实时超声造影比较研究

Comparison of enhancement features of primary hepatocellular carcinoma and recurrent hepatocelluar carcinoma on contrast-enhanced ultrasonography

目的 比较复发性与初发性肝细胞肝癌实时超声造影时相特征.方法 对初发性肝细胞肝癌患者83例（93个肿瘤）和复发性肝细胞肝癌患者56例（70个肿瘤）进行实时灰阶谐波超声造影,比较初发性肿瘤与复发性肿瘤的造影增强时相变化.结果 从注射造影剂开始到肿块回声较肝实质低的时间,复发性与初发性肝细胞肝癌组分别为（104.0±51.8）s和（85.5±43.0）s,两组间差别有显著统计学意义（P=0.010）.复发性和初发性肝癌在门脉期中表现为等回声的比例分别为34.3%（24/70）,17.2%（16/93）,前者明显高于后者（P=0.012）.结论 复发性肝细胞肝癌与初发性肝细胞肝癌超声造影表现有一定差异,认识这一规律将有助于复发性肝细胞肝癌的早期诊断.

Objective To compare enhancement features of primary hepatocellular carcinoma（PHCC）and recurrent hepatocellular carcinoma（RHCC） on.contrast-enhanced ultrasonography（CEUS）. Methods CEUS was performed in 56 patients with 70 RHCC and 83 patients with 93 PHCC. The enhancement features of these two groups of hepatocellular carcinoma were compared. The time used for the enhancement material to arrive the lesion（Ta ）, that used for the lesion to become isoechoic（T1 ） and hypoechoic relative to the surrounding hepatic parenchyma（To） were analyzed. The echogenicity change between the lesion and the parenchyma was observed during arterial phase,portal phase and delayed phase. Results The time used for the lesion to become hypoechogenicity of RHCC and PHCC was （104.0 ± 51.8）s, （85.5 ± 43.0）srespectively,there was significant difference between the two groups（ P = 0.010）. There were 24 （34.3 % ）cases of RHCC and 16 （ 17.2% ） cases of PHCC becoming isoechoic during portal phase,the former rate was significantly higher than the later one（ P = 0. 012）. Conclusions There is significant difference between PHCC and RHCC in the performance of CEUS,this is useful for the early diagnosis of RHCC.