肝癌高危人群的彩色多普勒超声定期筛查对诊断小肝细胞癌的应用价值

The Effect of Regular Examination of Color Doppler Ultrasound Method in the Diagnosis of Small Hepatocellular Carcinoma in High Risk Patients with Hepatocellular Carcinoma

目的探讨肝癌高危人群彩色多普勒超声定期筛查对诊断小肝细胞癌的的应用价值。方法运用常规超声法和彩色多普勒超声检查同时对81例属于肝癌高危人群的患者进行间隔为3个月的定期筛查,比较常规超声法和彩色多普勒超声检查对小肝细胞癌检出的灵敏性和特异性。另外,比较了已经确诊的56例小肝细胞癌患者和11例肝结节患者的回声模式和血流指数。比较不同体积肝癌的检出率和血流指数。结果彩色多普勒超声定期筛查是在检测敏感性、阴性检测率和符合率上都显著优于常规超声法(P<0.05),显示出更好的诊断性能。肝癌患者的病灶回声模式与肝结节患者差异显著,P<0.05。肝癌组病灶内或周围的最大血流速度和血流指数大于肝结节组,差异有统计学意义,P<0.05;肝癌组肝动脉的最大血流速度和血流指数大于肝结节组,差异有统计学意义,P<0.05。≤2.0 cm的肝癌病灶,彩色多普勒超声的检出率高于普通超声,差异有统计学意义,P<0.05。结论运用彩色多普勒超声检查对肝癌高危人群进行定期筛查,对及早诊断小肝细胞癌具有重要的意义。

Objective To study the effect of regular examination of Color Doppler ultrasound method in the diagnosis of small hepatocellular carcinoma in high risk patients with hepatocellular carcinoma. Methods A total of 81 high risk patients with hepatocellular carcinoma were enrolled in study. All patients underwent regular examinations per 3 months by conventional ultrasound and Color Doppler echocardiography. Comparison of the 56 cases have been diagnosed in patients with small hepatocellular carcinoma and 11 cases of patients with nodular echo patterns and flow index. Results Color Doppler ultrasound screening was significantly better than conventional ultrasound（ P〈0. 05） in the detection of sensitivity,negative detection rate and coincidence rate. The echo pattern of the lesions in patients with liver cancer was significantly different from those patients with hepatic nodules,P〈0. 05. The maximum blood flow velocity and blood flow index in the liver cancer group were significantly higher than that of liver,and the difference was statistically significant,P〈0. 05. The maximum blood flow velocity and blood flow index of the hepatic artery in the liver cancer group were more than that of the liver nodules group,and the difference was statistically significant,P〈0. 05. Less than 2. 0 cm of HCC lesions,the detection rate was higher than the ordinary color Doppler ultrasound,the difference was statistically significant,P〈0. 05. Conclusion It is worthy to apply regular examination of Color Doppler ultrasound in the diagnosis of small hepatocellular carcinoma in high risk patients,which may help them to receive proper therapy in time and extend their life span.