肝癌的三维彩色血管能量成像与临床病理对比研究

Three-dimensional color power angiography for primary liver cancer: correlation with clinicopathology

目的 探讨肝癌的三维彩色血管能量成像特征及其临床病理意义。方法 采用ATL HDI30 0 0超声仪 ,C4 2 超宽频探头 ,对 5 8例肝癌进行三维彩色血管能量成像 (3D CPA)检查 ,并对其进行TNM分期 ,以评价 3D CPA在肝癌预后评估中的价值。其中 30例进行 3D CPA检测与病理结果对比 ,病理观察指标包括癌瘤大小 ,肿瘤周边及内部血管形态、分布、排列、血管类型及肿瘤血管密度。结果 肿瘤周边弧形包绕血流和瘤内树枝状血流为肝癌 3D CPA特异性表现。肿瘤周边血管较肿瘤内部血管丰富 ;肿瘤直径越大 ,血管越丰富 ;3D CPA肿瘤血管分级与病理肿瘤血管密度相关 (P >0 .1) ,肝癌 3D CPA血管成像特征与病理检查结果相一致。TNM分期不同的肝癌 1年生存率不同 (P <0 .0 5 )。结论 3D CPA能反映肿瘤微血管水平的血流状况 ,在肝癌的血管显示、血管受累描述、TNM分期及病情判断、预后评价方面 ,3D

Objective To evaluate visualization of three dimensional color power angiography (3D CPA) for primary liver cancer (PLC) and its relation to clinicopathological significance.Methods ATL HDI 3000 ultrasonic system with C 4 2 superwide frequency transducer was available. Fifty eight cases were examined by 3D CPA and classified by TNM stage in order to assess prognostic value of 3D CPA for PLC. Contrastive study of 3D CPA with pathological outcome in 30 patients of hepatocellular carcinoma (HCC) was performed, pathological characteristics included size, microvessel density (MVD), and vascular pattern and distribution in tumor.Results Winding blood flows in tumor margin and intratumoral vessels like branches of trees were considered characteristics of 3D CPA of PLC. The blood flow signals were more abundant in tumor margin than in tumor center and in large tumor than in small one. Vascular classes according to 3D CPA visualization related to MVD(P> 0.1 ). The characteristics of 3D CPA for HCC corresponded to pathological findings. The survival rate in one year was different in different TNM stages of PLC(P< 0.05 ).Conclusions The characteristics of 3D CPA can reflect microvascular conditions for PLC. 3D CPA image diagnoses relating to clinicopathological factors for PLC can be made in vascular visualization, TNM stage and prognosis.