肝动脉血流动力学检测对肝癌、肝硬化的诊断价值及临床意义

The application of hepatic artery hemodynamics detection in diagnosis of liver cancer and cirrhosis

目的探讨肝动脉血流动力学检测对肝癌、肝硬化的诊断价值。方法将102例患者按照最终诊断结果分为肝癌组48例和肝硬化组54例,另选择同期在医院体检的健康人群50例作为对照组,采用彩色多普勒超声诊断系统检测各组受试对象肝动脉内径及血流频谱,并计算肝动脉血流量。结果肝癌组、肝硬化组肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量均高于对照组,其中肝癌组肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量高于肝硬化组,差异有统计学意义(P﹤0.05)。块状型肝癌肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量高于结节性肝癌和小肝癌,其中结节性肝癌肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量高于小肝癌,差异有统计学意义(P﹤0.05)。肝硬化C级患者肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量高于B级和A级肝硬化,其中B级肝硬化肝动脉内径、最高流速、最低流速、平均流速和肝动脉血流量高于A级肝硬化,差异有统计学意义(P﹤0.05)。结论肝硬化和肝癌均存在血流动力学异常变化,肝动脉动力学变化能够作为肝硬化和肝癌的危险信号之一,可作为早期诊断的依据。

Objective To explore the role and clinical significance of hepatic artery hemodynamics detection in liver cancer and cirrhosis patients. Methods A total of 102 patients were stratified as liver cancer group （n=48） and cirrhosis group （n=54）, according to respective final diagnosis, and another 50 cases of healthy adults who had taken physical ex-amination at the same period were included as the control group;the diameter and blood flow spectrum of the liver artery in each group were detected by color Doppler ultrasound, and the hepatic arterial blood flow was calculated. Result The diameter of hepatic artery, the highest, lowest, and average blood flow velocity, and blood flow volume in the liver cancer group and cirrhosis group were significantly higher than those in the control group （P〈0.05）, with higher observations in liver cancer group compared with the cirrhosis group （P〈0.05）, and those measures were higher in massive liver cancer than those with nodular hepatic carcinoma and small hepatocellular carcinoma （P〈0.05）, with higher observations in nod-ular hepatic carcinoma than those in small liver cancer （P〈0.05）. The diameter of hepatic artery, the highest, lowest, and average blood flow velocity and blood flow volume were highest in grade C of liver cirrhosis, followed by those in grade B and then grade A, and all differences were statistically significant （all P〈0.05）. Conclusion The changes of hepatic he-modynamics are both observed in cirrhosis and liver cancer, which may be used as predictors for early diagnosis.