超声造影在肝癌高危患者筛选诊断中的应用价值

The Application Value of Ultrasound Contrast in the Screening and Diagno-sis of Patients with High Risk of Liver Cancer

目的探讨常规超声(US)检查与超声造影检查在高危患者筛查中的应用。方法整群选取2013年6月—2015年6月收治的84例经肝细胞穿刺活检或术后病理组织检查确诊的肝脏局灶性病灶分别进行US检查及超声造影检查,分析两种诊断方法准确率,病灶大小数目及患者在US及超声造影中的影像学特征。结果 US在诊断肝脏良性病变中的符合率与超声造影相当(P>0.05),而在肝癌诊断中超声造影组诊断准确率显著高于US组(P<0.05)。超声造影组在直径≤1 cm微小肿瘤诊断中的符合率大于US组(P<0.05)。与肝炎型假瘤、肝局灶性增生结节、肝血管瘤患者相比,原发性肝癌、转移性肝癌患者超声造影始消时间及持续时间更长(P<0.05)。结论与US相比,超声造影对肝癌的诊断率更加准确,更便于尽早分辨出恶性病灶及微小病灶。且不同性质的肝脏局灶性病灶在超声造影中表现出不同的增强方式,能有效鉴别不同种类的肝脏局灶性病灶。

Objective To investigate the application of conventional ultrasound (US) and ultrasound contrast for the screening of patients with high risk of liver cancer. Methods 84 patients confirmedly diagnosed with hepatic focal nodular hyperplasia by liver biopsy or postoperative pathological tissue examination underwent both US and ultrasound contrast from June 2013 to June 2015. And an analysis was conducted on the diagnostic accuracy of the two diagnostic methods, the size and number and imaging features of lesions in US and ultrasound contrast of the patients. Results The diagnostic coincidence rate of benign liver lesions diagnosed by US was consistent with that by ultrasound contrast(P>0.05). The diagnostic accuracy of liver cancer in ultrasound contrast group was much higher than that in US group (P<0.05). The diagnostic coincidence rate of small tumor with diameter ≤1cm in ultrasound contrast group was much higher than that in US group (P<0.05). Compared with patients with inflammatory pseudotumor of the liver, hepatic focal nodular hyperplasia patients, hepatic hemangioma patients, patients with primary liver cancer and those with metastatic liver cancer had much longer washout time and duration time of ultrasound contrast (P<0.05). Conclusion Compared with US, ultrasound contrast has much higher diagnostic rate of liver cancer, which can distinguish malignant lesions and small lesions as early as possible. Focal hepatic lesions with different characteristics show different enhancement mode in ultrasound contrast. Ultrasound contrast can effectively identify different types of focal hepatic lesions.