超声对原发性肝癌和肝血管瘤鉴别诊断的研究进展

Research progress in the differential diagnosis of primary liver cancer and hemangiomas by ultrasound

原发性肝癌是全球范围内的主要公共卫生问题.原发性肝癌发生是分子、细胞和组织学水平的复杂多步骤过程,其关键变化可通过非侵入性成像方式揭示.因此,成像技术在原发性肝癌的检测、表征、分期、监测和预后评估中起着关键作用.当前,超声是用于筛查和监视目的的一线成像方法.对比增强动态计算机断层扫描(Computed tomography,CT)和磁共振成像(Magnetic resonance imaging,MRI)是原发性肝癌的诊断工具,无需组织病理学确认.肝血管瘤按病理可分为4型:海绵状血管瘤最为常见;硬化性血管瘤;血管内皮细胞瘤;毛细血管瘤.良性肝脏病变如果表现为无回声性囊肿或均质的高回声性血管瘤,则可以通过常规的灰度和彩色多普勒来表征,因此超声对诊断该疾病是一种必不可少的辅助检查手段和重要工具,在临床检测中具有重要的意义.本综述讨论了超声对原发性肝癌和肝血管瘤鉴别诊断的研究进展.

Primary liver cancer is a major public health problem worldwide.The occurrence of primary liver cancer is a complex,multi-step process at the molecular,cellular,and histological levels,and its key changes can be revealed through non-invasive imaging.Therefore,imaging technology plays a key role in the detection,characterization,staging,monitoring,and prognostic evaluation of primary liver cancer.Currently,ultrasound is the first-line imaging method for screening and surveillance purposes.Although based on conclusive enhancement models including arterial hyperenhancement and portal vein and/or delayed irrigation,contrast-enhanced dynamic computed tomography(CT)and magnetic resonance imaging(MRI)are primary liver cancers Diagnostic tool without histopathological confirmation.Hepatic hemangioma can be divided into 4 types according to pathology:cavernous hemangioma is the most common;sclerosing hemangioma;hemangioendothelial cell tumor;capillary hemangioma.If benign liver lesions are manifested as anechoic cyst or homogenous hyperechoic hemangioma,they can be characterized by conventional grayscale and color doppler.Therefore,ultrasound is an indispensable auxiliary examination and important tool for the diagnosis of this disease,which has important significance in clinical detection.In this review,we discuss the progress of ultrasound in the differential diagnosis of primary liver cancer and hepatic hemangioma.