超声造影诊断微小原发性肝癌患者临床价值研究

C ontrast-enhanced ultrasound monitoring in early diagnosis of patients with small primary liver cancer

目的探讨肝脏超声造影检查诊断微小原发性肝癌(PLC)的临床价值。方法 2016年1月~2016年12月于我院监测的PLC高危人群156例,在常规超声检查后对有目标或高度怀疑的患者行超声造影检查,并在15 d内行电子计算机断层扫描(CT)或磁共振成像(MRI)检查,经手术组织或穿刺活检组织病理学检查诊断。结果在156例PLC高危人群中,常规超声检查诊断恶性占位29例,可疑恶性14例;经超声造影检查,诊断恶性占位32例,可疑恶性9例。经CT、MRI和手术后或穿刺活检组织病理学检查,诊断为肝细胞癌(HCC)32例,可疑恶性9例。在32例HCC患者中,男17例,女15例;年龄20~69岁,平均年龄(48.56±2.05)岁。病灶直径0.8~2 cm,平均(1.62±0.12)cm;在确诊的32例微小HCC患者中,13例超声造影显示动脉早期瘤体完全增强,而门脉期和延迟期表现为低回声,呈现典型的"快进快出"增强模式,19例造影剂超过6 min未廓清,呈"快进同出"型。结论针对PLC高危人群,对其行肝脏超声造影定期跟踪监测,有助于发现早期微小PLC病灶。

Objective To investigate the clinical application of ultrasonography in the early diagnosis of patients with small primary liver cancer（PLC）.Methods 156 individuals with high risk of PLC were monitored by ultrasonography in the Department of Oncology between January 2016 and December 2016 in this study.Computed tomography（CT）,and magnetic resonance imaging（MRI） were performed within 15 days after contrastenhanced sonography.The pathologic diagnosis was made by surgical histopathological examination or fine needle biopsy.Results Out of the 156 persons with high risk of PLC,29 malignant and 14 suspected malignant foci were found by routine sonography,while 32 malignant and 9 suspected malignant foci were detected by contrastenhanced sonography;32 hepatocellular caicinoma（HCC） and 9 suspected malignant foci were confirmed by pathology;out of the 32 patients with HCC,17 were men,and 15 women with a average age of 48.56±2.05（20~69） yr,the diameter of foci was 0.8 ~2（1.62 ±0.12） cm,and the foci was arterial enhancement and hypoechogenicity in portal and delayed phase in 13,and keeping enhancement in three phase in 19.Conclusions Regular monitoring of ultrasonography is necessary in individuals with high risk of PLC for early diagnosis of malignant foci.