超声造影在肝癌分级应用中的前瞻性研究

A Prospective Study of the Application of Contrast-enhanced Ultrasonography on Liver Cancer Classification

目的:利用超声造影研究高分化和低分化肝癌患者的肿瘤血流灌注情况,探讨超声造影在肝癌分级的诊断价值。方法:选择我院原发性肝癌(HCC)患者65例并根据活检肝细胞癌病变和肿瘤分级不同分为A组37例(高分化组)和B组28例(低分化组),对两组患者行超声造影检查,分析超声造影的血流灌注状态。结果:A组与B组病灶的到达时间(AT)、峰值时间(TTP)和峰值强度(PI)均存在显著的差异性(tAT=7.266,PAT=0.000;t TTP=5.966,P TTP=0.000;tPI=8.219,PPI=0.000)。A组与B组间的病灶增强时间(1)、增强斜率(2)、清除时间(3)、清除斜率(4)具有差异,并且差异具有统计学意义(t1=7.266,P1=0.000;t2=8.317,P2=0.000;t3=8.880,P3=0.000;t4=6.178,P4=0.000)。结论:超声造影可作为一种新型的肝癌分级方法,对于早期诊断肝癌和获得肿瘤分级具有很大的临床价值。

Objective： To study the tumor perfusion of patients with well differentiated and poorly differentiated hepatocellular carcinoma using contrast-enhanced ultrasonography in order to explore the value of contrast-enhanced ultrasonography in liver cancer classification. Methods：Sixty-five patients with primary hepatocellular carcinoma （HCC） in our hospital were divided into group A （well differentiated） with 37 cases and group B （poorly differentiated） with 28 cases according to the HCC lesions biopsy and tumor grade. Patients in two groups underwent ultrasound scanning. The perfusion status of contrast-enhanced ultrasonography was analyzed. Results： The differences of arrival time （AT）, time to peak（TTP） and peak intensity（PI） in group A and B were significantly different （tAT=7.266, PAT=0.000;t TTP =5.966, P TTP =0.000;tPI=8.219, PPI=0.000）. The differences of enhancement time （1）, enhancement slope （2）, outflow time （3） and clear slope （4） in group A and B were significantly different （t1=7.266,P 1=0.000 ;t2=8.317, P2=0.000;t3=8.880, P3 =0.000;t4=6.178,P4=0.000）. Conclusions： contrast-enhanced ultrasonography is hopefully to be a new method in liver cancer classification. It shows great value for early diagnosis of liver cancer and tumor grade.