超声在原发性小肝癌诊断中的临床价值

Clinical value on diagnosis of primary small hepatocellular carcinoma with ultrasonography

目的探讨超声对小肝癌的诊断价值。方法收集经手术及病理或穿刺活检证实的小肝癌共39例及肝脏良性小肿瘤18例进行分析。结果肝脏良性、恶性小肿瘤的二维图像表现有一定区别,但部分病例表现相似,并有部分小肝癌在二维图像上难以显示,组织谐波显像(THI)对小肝癌的图像显示清晰,小肝癌病灶内及周边彩色多普勒血流显像(CDFI)及能量多普勒(CDE)血流显示率明显高于良性小肿瘤,小肝癌病灶内及周边CDE血流显示率明显高于彩色多普勒血流显示率,小肝癌病灶内及周边动脉峰值血流速度(PS)及阻力指数(RI)明显高于良性小肿瘤(P<0.01),小肝癌患者的肝动脉PS及RI明显高于良性小肿瘤的患者。结论 THI能为小肝癌提供高清晰度的声像图,结合CDFI及CDE对小肝癌的诊断具有重要意义。

Objective To evaluate the value of the ultrasound in the diagnosis of small hepatocellular carcinoma. Methods Thirty nine patients with small hepatocellular carcinoma and 18 patients with benign liver tumor were analyzed by using two dimensional ultrasonography and color Doppler ultrasound. Results Liver benign and malignant small tumors have a certain difference between the performance of two-dimensional image, but some cases were similar and some small hepatocellular carcinoma were difficult to show in two-dimensional images, tissue harmonic imaging （THI） on the small hepatocellular carcinoma showed clear images, color Doppler （CDFI） and power Doppler （CDE） showed blood flow of small liver cancer in lesion and surrounding were significantly higher than benign small tumor, CDE showed blood flow of small hepatocellular carcinoma in lesion and surrounding were significantly higher than CDFI. Artery peak flow velocity （PS） and resistance index （RI） of small liver cancer in lesion and surrounding were significantly higher than benign small tumor （P〈0.01）, PS and RI of small liver cancer were significantly higher than benign small tumor. Conclusion THI combined with CDFI and CDE have great significance to the diagnosis of small hepatocellular carcinoma.