超声造影对原发性肝细胞癌的诊断及与病理分化程度的关系

Contrast-enhanced ultrasonography in the diagnosis of primary hepatocellular carcinoma and correlation with pathology

目的观察原发性肝细胞癌(hepatocellular carcinoma,HCC)超声造影各时相特点,探讨不同增强模式与病理分化程度的关系。方法选择行超声造影检查诊断为HCC,且住院手术最终病理结果为HCC的患者23例作为研究对象。根据病理结果分为高分化组(10例)和中低分化组(13例)。分析其血流灌注特征,并绘制时间-强度曲线,分析造影时间-强度曲线各参数与病理分化程度的关系。结果 23例肝细胞癌动脉相呈快速高增强。中低分化组92.3%(12例)门静脉相快速退出,7.7%(1例)门静脉相缓慢退出;高分化组70%(7例)门静脉相缓慢退出,30%(3例)门静脉相快速退出。两组中增强斜率、增强时间、相对峰值强度、峰值强度比值、峰值降半时间以及下降斜率比较差异有显著性意义(P<0.05)。结论原发性肝细胞癌造影增强表现与病理分化程度有直接关系。

Objective To observe the appearance and characterization in every vascular phase of primary hepatocellular carcinoma （HCC） with contrast -enhanced ultrasonography and to evaluate whether the enhancement pattern correlates with the degree of pathological differentiation. Methods Of the patients who received contrast - enhanced ultrasonography, 23 patients with pathologically confirmed HCC were reviewed. The blood perfusion characteristics were observed. Time - intensity curve （TIC） was drawn and the relationship was explored between the parameters of TIC and the degree of pathological differentiation. Results All 23 HCCs were enhanced in the arterial phase. Among them, 13 were moderately to poorly differentiated HCCs with 92.3% （ 12 lesions） quickly washed out and 7.7% （ 1 lesion） slowly washed out in the portal venous phase; 10 were well -differentiated HCCs with 70% （7 lesions） slowly washed out and 30% （3 lesions） quickly washed out in the portal venous phase. When the two groups were compared, the parameters had significant differences （ P 〈 0.05 ） among contrast - enhanced slope and time, relative peak intensity, peak intensity ratio, 1/2 peak time and falling slope. Conclusions The enhanced manifestations of primary HCCs are directly related to the degree of pathological differentiation .