原发性肝癌超声造影特征与病理对照研究

The control study of pathology and contrast-enhanced ultrasonography for primary hepatic carcinoma

目的探讨超声造影特征与原发性肝癌组织类型和分化程度的关系。方法对62例原发性肝癌患者进行了超声造影检查,其中肝细胞肝癌48例、胆管细胞癌14例,分析肝癌的强化模式,并与病理结果进行对照。结果动脉期肝细胞肝癌等-高增强率97.9%(47/48)、低增强率2.1%(1/48),胆管细胞癌等-高增强率21.4%(3/14)、低增强率78.6%(11/14),延迟期肝细胞肝癌等-低增强率93.8%(45/48)、高增强率6.3%(3/48),胆管细胞癌等-低增强率35.7%(5/14)、高增强率64.3%(9/14)。增强特征在动脉期肝细胞肝癌与胆管细胞癌比较差异有统计学意义(P<0.01),门静脉期肝细胞肝癌与胆管细胞癌比较差异无统计学意义(χ2=0.984,P>0.05),延迟期肝细胞肝癌与胆管细胞癌比较差异有统计学意义(χ2=31.001,P<0.01)。不同分化程度的肝细胞肝癌,开始增强时间和峰值时间差异均无统计学意义(F=2.784和2.982,P>0.05),而增强开始消退至低回声时间差异有统计学意义(F=75.431,P<0.01)。结论超声造影特征与原发性肝癌组织类型和分化程度相关。

Objective To investigate the relationship between Contrast-enhanced ultrasonography（CEUS）and the histolog-ical types and differential extent of primary hepatic carcinoma（PHC）.Methods Sixty-two patients with primary hepatic carcinoma were examined with CEUS,including 48 cases hepatocelluar carcinoma（HCC）and 14 cases intrahepatic cholangiocarcinoma（ICC）,and enhancement patterns were analyzed and compared with pathological results.Results During arterial phase,the rates of iso-enhancing-hyper-enhancing and hypo-enhancing in HCC were 97.9%（47/48）and 2.1%（1/48）respectively,and that in ICC were 21.4%（3/14）and 78.6%（11/14）（P0.01）respectively.During parenchymal phase,the rates of iso-enhancing-hypo-enhancing and hyper-enhancing in HCC were 93.8%（45/48）and 6.3%（3/48）,and that in ICC were 35.7%（5/14）and 64.3%（9/14）（χ2=31.001,P0.01）.However,no significant difference was found during portal phase between HCC and ICC.Among different differential HCC,no significant difference was showed in the initial enhancing time and peak time（P0.05）,but there was a significant difference in time that tumor became hypo-enhancing（P0.01）.Conclusions There is a correlation between the features of Contrast-enhanced ultrasonography and the histological types and differentiation extent.