肝结核结节与肝肿瘤超声影像特征分析

Ultrasonographic features of hepatic nodular nodules and liver tumors

目的探讨肝结核结节与肝肿瘤超声影像特征与鉴别诊断价值。方法选取2016年7月至2017年12月间延安市第二人民医院收治的72例肝结核结节与肝肿瘤患者作为研究对象,其中,肝结核结节12例纳入结核组,肝肿瘤60例纳入肿瘤组,记录所有患者的常规超声特征与超声造影指标,并比较两种检查方法的诊断价值。结果结核组病灶动脉期多表现为向心内增强与等增强表现,门静脉期多表现为等回声。肿瘤组病灶在动脉期多表现为整体增强与周边增强,在门静脉期多表现为低回声。肿瘤组病灶的超声造影开始增强时间显著高于结核组,差异有统计学意义(P<0.05),两组患者的达峰值强度时间比较,差异无统计学意义(P>0.05)。超声造影诊断结果中,肝结核结核11例,肝肿瘤61例,超声造影鉴别诊断的敏感性与特异性分别为91.7%和100.0%。结论超声造影可显示肝结核结节与肝肿瘤血管的早期灌注状态,可为两者的鉴别与诊断提供新的重要信息。

Objective To investigate the uhrasonographic features and differential diagnosis values of tuberculous nodule and liver tumors. Methods From July 2016 to December 2017, 72 patients with he- patic tuberculosis nodules and liver tumors treated at The Second People＇s Hospital of Yah＇an were selected as the research subjects among which 12 were patients with hepatic tuberculosis nodules （tuberculosis group） and 60 were patients with liver tumors （ tumor group）. The characteristics of conventional ultrasound and contrast-enhanced ultrasound were recorded in all the patients, and the the diagnostic value were stud- ied. Results In the tuberculosis group, most of the lesions were the centripetal enhancement and the en- hancement in the arterial phase, and were equal echoes in the portal venous phase. In the tumor group, most of the lesions were entire enhancement and peripheral enhancement in the arterial phase, and most were low echo in the portal venous phase. The time of ultrasound contrast enhancement in the tumor group were significantly higher than in the tuberculosis group （ P 〈 0. 05 ）. There were no significant difference in the peak intensity time between the two groups （ P 〉 0. 05 ）. Eleven patients with hepatic tuberculosis and 61 patients with liver tumors were diagnosed by contrast-enhanced ultrasound. The sensitivity and specificity of contrast-enhanced ultrasound in differential diagnosis were 91.7% and 100.0%, respectively. Conclu- sion The contrast-enhanced ultrasound can show the early perfusion state of hepatic tuberculous nodules and hepatic tumor vessels, which can reflect the blood supply of tumors more realistically, which provides new important information for their identification and diagnosis.