阻力指数对超声诊断肝脏肿瘤及肿瘤样病变的价值

VALUE OF RESISTENT INDEX IN ULTRASONIC DIAGNOSIS OF LIVER TUMORS AND TUMOR-LIKE LESIONS

目的探讨阻力指数(RI)在超声诊断肝脏肿瘤及肿瘤样病变中的价值。方法对143例肝脏肿瘤及肿瘤样病变病人的168个病灶进行彩色多普勒血流显像和脉冲多普勒血流检查分析。结果原发性肝癌90例103个病灶,其中并门静脉癌栓广泛形成3例;转移性肝癌4例11个病灶。肝血管瘤23例28个病灶,肝腺瘤15例15个病灶,肝脏局灶性结节性增生9例9个病灶,炎性假瘤2例2个病灶。12例肝血管瘤14个病灶经CT或(和)MRI扫描及随访得以诊断,3例原发性肝癌并门静脉癌栓广泛形成病人经其他影像学检查及临床实验室检查证实,余者均经手术或穿刺活检病理证实。肝脏恶性肿瘤RI明显高于肝脏良性肿瘤及肿瘤样病变(t=9.74,P<0.05)。结论 RI在肝脏肿瘤及肿瘤样病变的超声诊断及鉴别诊断中有重要的参考价值。

Objective To evaluate diagnostic value of resistent index（RI） in Doppler ultrasonography for liver tumors and tumor-like lesions.Methods Color Doppler and pulse Doppler flow imaging were examined and analyzed in 168 nidi of 143 patients with liver tumor or tumor-like lesions.Results The findings were as follows： primary liver cancer（90 cases;103 nidi）,in which,cancer embolus in portal vein was identified in three patients;metastatic hepatic carcinoma（4;11）;hepatic hemangioma（23;28）;hepatic adenoma（15;15）;focal nodular hyperplasia（9;9）;inflammatory pseudotumor（2;2）.The diagnosis of 12 patients（14 nidi） with liver hemangioma was confirmed by CT and/or MRI and follow-up;those three with cancer embolus in portal vein were identified by other image analysis and laboratory tests.The others were confirmed by surgery or puncture biopsy.RI of hepatic carcinoma was higher than that of benign liver tumors and tumor-like lesions（t=9.74,P〈0.05）.Conclusion The parameter RI has an important value for reference in ultrasonograpic diagnosis and differential diagnosis of tumors and tumor-like lesions of liver.