超声造影具较高肝硬化合并小肝癌的早期诊断率

Contrast-Enhanced Ultrasound Mightay Have High Early Diagnostic Rate in Small Hepatocellular Carcinoma(SHCC) with Cirrhosis

为研究超声造影(CEUS)对肝硬化合并小肝癌(SHCC)的早期诊断价值,本研究随机选取肝硬化合并小肝癌患者33例,共计病灶36个。对透明细胞癌病灶的造影显示,其开始增强时间和增强峰值时间均大于中、低、高分化癌,而开始消退时间显著大于中低分化癌,显著低于高分化癌(p<0.05);对小肝癌病灶的造影显示,开始增强时间与增强峰值时间差异不显著(p>0.05),而高分化癌的开始消退时间显著高于中低分化癌(p<0.05);关于超声造影增强模式,病灶在不同分化期呈现出了不同的造影特点。超声造影后,10个病灶较超声造影前诊断评分有所提高,其中5个病灶的诊断评分较超声造影前提高2分。经回顾性分析算得91.67%的病灶检出病情,69.44%的病灶可确诊。结果表明,超声造影对肝硬化合并小肝癌的确诊率较高,本研究为肝硬化合并小肝癌的临床分析提供了诊断依据。

In order to study the early diagnostic value of contrast-enhanced ultrasound （CEUS） in treating small he- patocellular carcinoma （SHCC） with cirrhosis, we randomly selected 33 cases of SHCC with cirrhosis, and totally o- btained 36 lesions. Contrast-enhanced ultrasound of clear cell carcinoma lesions showed that their appearing time and peak time were later than those of moderate, poor and high differentiated carcinomas, and their disappearing time was significantly later than that of moderate and poor differentiated carcinomas, but earlier than that of high differentiated carcinomas （p〈0.05）; Contrast-enhanced ultrasound of SHCC lesions indicated that the differences among the appearing and peak time of moderate, poor and high differentiated carcinomas were not significant （p 〉0.05）, while the disappearing time of high differentiation carcinoma was significantly later than that of moderate and poor differentiated carcinomas （p〈0.05）. As for the enhanced mode of CEUS, lesions demonstrated different imaging characteristics at different differentiation stages. After treating by CEUS, the diagnostic score of 10 lesions increased compared with that before CEUS, of which the diagnostic score of 5 lesions increased by 2 points. Through retrospective analysis, 91.67% of the lesions were detected, and 69.44% were diagnosed. The results indicated that contrast-enhanced ultrasound might have high early diagnostic rate in small hepatocellular carcinoma with cirrhosis, which would provide a diagnostic basis for the clinical analysis of SHCC with cirrhosis.