肝脏神经内分泌肿瘤与肝细胞癌超声学特征的差异比较

Comparison of ultrasonographic characteristics between haptic neuroendocrine neoplasm and hepatocellular carcinoma

目的比较肝脏神经内分泌肿瘤(HNEN)、肝细胞癌超声学特征的差异。方法选取2017年2月至2019年8月期间就治于郑州大学附属肿瘤医院的肝脏HNEN患者22例,同时随机选取同期肝细胞癌患者30例,比较两组患者的超声特征,统计学处理采用t检验和卡方检验。结果HNEN、肝细胞癌常规超声特征中,病灶平均数目、边界、病灶内部回声、回声均匀性及后方回声衰减等具有显著差异(P<0.05),而病灶位置、大小及血流信号等无明显统计学差异(P>0.05)。HNEN、肝细胞癌超声造影特征中,开始消退时间、增强持续时间及消退速度等具有显著差异(P<0.05),而开始增强时间、增强速度、增强形式及增强强度等无明显统计学差异(P>0.05)。结论基于超声及超声造影的检查能够有效反映HNEN和肝细胞癌的差异,有助于临床实践中对两种病灶的鉴别。

Objective To compare the ultrasonographic characteristics between hepatic neuroendocrine neoplasm(hNEN)and hepatocellular carcinoma.Methods Twenty-two patients with hNEN treated in our department from February 2017 to August 2019 were selected,including 14 males and 8 females,1 case of primary hNEN and 21 cases of metastatic hNEN,with an average age of(50.6±10.0)years.The primary sites of metastatic hNEN included pancreas(n=8),stomach(n=5),small intestine(n=4),colorectal(n=3)and lung(n=1).During the same period,30 patients with hepatocellular carcinoma were randomly selected,including 23 males and 7 females,26 cases of primary hepatocellular carcinoma and 4 cases of metastatic hepatocellular carcinoma,with an average age of(52.2±7.9)years.The measurement data were expressed as(±s),compared with t-test,and the count data were expressed as(%)and compared with chi-square test.Results Using conventional ultrasound,there were significant differences in the average number of lesions,boundary,internal echo,echotexture and posterior echo attenuation between hNEN and hepatocellular carcinoma(P<0.05).There was no significant difference in lesion location,size and blood flow signal(P>0.05).Using contrast-enhanced ultrasound,there were significant differences in the initial enhancement washout time,enhancement duration and washout rate between hNEN and hepatocellular carcinoma(P<0.05).There was no significant difference in initial enhancement time,enhancement rate,enhancement pattern and enhancement degree(P>0.05).Conclusion Both conventional ultrasound and contrast-enhanced ultrasonography can effectively show the difference between hNEN and hepatocellular carcinoma,which were helpful to the differentiation of the 2 kinds of lesions in clinical practice.