超声造影测量肝脏肿瘤大小的病理研究——与常规超声、CT比较

Pathological analysis about liver tumor size measured with contrast enhanced ultrosonography compared with baseline ultrosonography and CT

目的研究超声造影测量肝脏肿瘤大小的准确性,探讨超声造影判定肝恶性肿瘤局部浸润范围的价值。方法 54例肝脏肿瘤患者共61个病灶手术前进行常规超声、增强CT及超声造影检查测量病变最大长径,3种方法的测量值与肉眼测量手术标本大小比较及病理切片对照。结果常规超声、增强CT及超声造影3种方法的测量值与手术后标本大小比较差异没有统计学意义,具有较好的相关性(r值分别为0.904、0.901和0.894),其中超声造影测量值大于肉眼测量手术标本大小,均值差为0.35cm,常规超声和增强CT测量值小于肉眼测量手术标本大小,均值差分别为0.06cm和0.08cm。将肝脏恶性肿瘤分为超声造影较常规超声增大组和未增大组,比较二者病理切片镜下肿瘤细胞向非肿瘤组织浸润的深度,两组均值比较差异有统计学意义(P<0.05)。结论 3种方法对肝脏肿瘤的测量值均较准确,常规超声及增强CT能准确地测量大体肿瘤大小,超声造影可准确反映恶性肿瘤浸润范围。

【Objective】 To investigate accuracy of measurement of liver tumor size with contrast enhanced ultrasonography（CEUS） and to evaluate local infiltration of liver tumor judged with CEUS.【Methods】 54 patients with 61 liver tumors underwent baseline ultrasonography,contrast enhanced CT（CECT） and CEUS before hepatoectomy.The tumor size was measured with baseline ultrasonography,CECT and CEUS at the largest section and then compared with the resected gross and microscopic findings.The infiltration depth of the malignancies,the pathological character of the tumor and tissues surrounding the tumor were analyzed.【Results】 There was no significant difference among liver tumor sizes measured on Baseline ultrasonography,CECT and CEUS,with better correlation with the size of the resected gross specimen（r =0.904,0.901,0.894 respectively）.Of them,the size on CEUS was larger than the size on the resected gross specimen,which mean difference was 0.35 cm.the sizes on baseline ultrasonography and CECT were smaller than the size on the resected gross specimen,which mean difference was 0.06 cm and 0.08 cm respectively.There was significant difference in terms of the infiltration depth of the malignancies between lesions with the larger size on CEUS than that on baseline ultrasonography and the others with the same size on CEUS and on baseline ultrasonography（P 0.05）.【Conclusions】 Baseline ultrasonography,CECT and CEUS can accurately measure the size of liver tumor.The contrast enhanced area on CEUS can accurately reflect the area of infiltrative malignancies.