超声造影与CT在肝细胞癌诊断中的比较

Comparison of contrast-enhanced ultrasonography and CT scan in diagnosis of HCC

目的评价超声造影与CT在肝细胞癌诊断中的价值。方法应用常规超声对35例患者观察肝细胞癌的可疑部位、范围及内部回声,然后在灰阶超声造影条件下静脉团注造影剂2.4 ml,观察肝细胞癌的部位、范围及造影增强特征;应用CT对35例肝癌患者扫描。所有结果与病理学检查进行对照分析。结果灰阶超声造影可清晰显示34例肝细胞癌的部位、形态、范围,1例肝细胞癌灶未显示,其显示肝细胞癌的敏感性为97.1%(34/35)。增强CT可清晰显示肝内的28个肝细胞癌灶,另7个肝细胞癌灶未显示,敏感性为80.0%(28/35),超声造影敏感性高于CT(P<0.05)。在判断肝细胞癌上,超声造影与病理学检查具有较好的一致性。结论超声造影剂结合灰阶超声造影技术可显著提高常规超声对肝细胞癌的诊断水平,与CT比较具有一定的优势。

Objective To compare the diagnostic value of contrast-enhanced ultrasonography（CEUS） in the diagnosis of human hepatocellular carcinoma（HCC） with CT.Methods Conventional ultrasonography and gray scale CEUS were performed to detect the positions and dimensions of the HCC lesions in 35 patients.The patients received intravenous bolus injection of 2.4ml contrast media.We observed the positions of hepatocellular carcinoma,scope and characteristics of contrast-enhanced.The results of CEUS were compared with enhanced-CT and pathologic findings.Results The position,morphology and range of the HCC Lesions in 34 patients were displayed clearly on the enhanced images and the other one showed no HCC lesions（34/35）.The sensitivity of gray scale CEUS detecting the HCC lesions was significantly higher than that of CT scan（97.1% vs 80.0%）,（P0.05）.Enhanced CT only displayed 28 lesions.Seven of the 35 Lesions misdiagnosed on CT（28/35）.The HCC Lesions evaluated by CEUS were consistent with pathology.Conclusion Gray scale CEUS may improve the diagnostic accuracy of ultrasound and is superior to CT in the diagnosis of the HCC Lesions.