超声造影在肝细胞癌和肝局灶性结节增生鉴别诊断中的价值

Value on The Differential Diagnosis of Ultrasound Contrast in Hepatocellular Carcinoma and Hepatic Focal Nodular Hyperplasia

目的探讨超声造影在肝细胞癌(HCC)和肝局灶性结节增生(FNH)鉴别诊断中的价值。方法选取2012年1月1日至2014年1月1日期间笔者所在医院收治的23例HCC患者和23例肝FNH患者,术前均行超声造影检查,对2组患者的超声造影结果进行对比分析。结果 HCC组造影剂到达时间为(3.8±1.9)s,明显长于肝FNH组的(2.3±1.4)s;达峰时间为(21.8±11.9)s,显著短于肝FNH组的(35.3±14.8)s;峰值强度为(28.8±3.1)d B,显著高于肝FNH组的(22.3±7.9)d B,其差异均有统计学意义(P<0.05)。HCC组患者超声造影诊断的敏感度、特异度、准确性分别为91.3%(21/23)、87.0%(20/23)和95.7%(22/23),肝FHN组患者超声造影诊断的敏感度、特异度、准确性分别为87.0%(20/23)、91.3%(21/23)和91.3%(21/23),2组间比较其差异均无统计学意义(P>0.05)。结论超声造影在HCC和肝FNH的鉴别诊断中具有十分重要的应用价值,可在临床推广应用。

Objective To investigate the value of ultrasound contrast in the differential diagnosis for hepatocellular carcinoma （HCC） and hepatic focal nodular hyperplasia （FNH）. Methods Twenty-three HCC patients and 23 cases hepatic FNH patients from January 1, 2012 to January 1, 2014 in our hospital were selected, all of them were underwent ultrasound contrast examination before operation. The ultrasound contrast results of 2 groups patients were comparative analyzed. Results In HCC group, the contrast arrival time was （3.8_＋1.9） s, peak time was （21.8_＋ 11.9） s, and peak strength was （28.8 _＋3.1） dB; in hepatic FNH group, these indicators was （2.3_＋1.4） s, （35.3_＋14.8） s, and （22.3_＋7.9） dB, respectively. These indicators of HCC group was longer or shorter or higher than those of hepatic FNH group, respectively （P〈0.05）. The sensitivity, specificity, and accuracy of ultrasound contrast diagnosed HCC was 91.3% （21/23）, 87.0% （20/23）, and 95.7% （22/23）, and diagnosed hepatic FHN was 87.0% （20/23）, 91.3% （21/23）, and 91.3% （21/23）, respectively, the difference were not statistically significant between the two groups （P〉0.05）. Conclusion Ultrasound contrast has very important application value in the differential diagnosis of HCC and hepatic FNH, can be used in clinical application.