超声造影诊断≤10 mm肝细胞肝癌的应用价值研究

Value of contrast-enhanced ultrasound in diagnosis of ≤10 mm hepatocellular carcinomas

目的:探讨≤10 mm肝细胞肝癌(hepatocellular carcinoma,HCC)超声造影的特征。方法:回顾性分析手术病理学检查证实的34例≤10 mm HCC病灶的超声造影图像特征,总结超声造影时相变化。结果:34例共34个病灶中,100%(34个)表现为动脉期高回声增强,61.8%(21个)表现为门静脉期低回声增强,38.2%(13个)表现为门静脉期等回声增强,其中延迟期减退7例,延迟期仍呈等回声6例。在≤10 mm HCC的超声造影中,开始增强时间、达峰时间、呈等回声及低回声时间分别是(18.56±3.94)、(23.88±4.59)、(32.33±6.54)及(134.21±66.38)s。若以动脉期高回声增强,门静脉期及延迟期低回声增强作为诊断指标,超声造影诊断≤10 mm HCC的准确率为61.8%。若以动脉期出现高回声增强,门静脉期呈等或低回声增强,延迟期呈低回声增强为诊断指标,其准确率为82.4%;若再结合既往肿瘤病史,其诊断准确率可达91.1%。结论:超声造影时相分析有助于提高≤10 mm HCC的诊断准确率。

Objective:To evaluate the value of contrast-enhanced ultrasound(CEUS)in the diagnosis of≤10 mm hepatocellular carcinoma(HCC).Methods:Thirty-four cases with pathologically proven≤10 mm HCC were enrolled in this study and the image features on CEUS were analyzed retrospectively.Results:All cases were hyper-enhanced in arterial phase.61.8%(21/34)were hypoenhanced and 38.2%(13/34)were iso-enhanced in portal venous phase.In those cases with iso-enhancement in portal vein phase,7 cases showed hypo-enhancement and 6 cases showed iso-enhancement in delayed phase.The average enhancement initial time,the time to peak,the time to isoechogenity,and the time to hypoechogenicity were(18.56±3.94),(23.88±4.59),(32.33±6.54),and(134.21±66.38)s,respectively.The diagnostic accuracy was 61.8%if the diagnostic standard for≤10 mm HCC was set as hyperenhancement in arterial phase and hypo-enhancement in portal venous and delayed phases;However,the diagnostic accuracy was improved to 82.4%if the standard was hypo-enhancement in arterial phase and hypo-enhancmeent or iso-enhancement in portal venous phase and hypo-enhancement in delayed phase.Furthermore,the diagnostic accuracy was improved to 91.1%when combining HCC history.Conclusion:Analysis of contrast phase for≤10 mm HCC might be helpful in improving the diagnostic accuracy.