肝脏 ›› 2020, Vol. 25 ›› Issue (8): 835-836.

• 肝癌 • 上一篇    下一篇

SonoVue超声造影对不典型肝脏局灶性病灶的鉴别诊断价值

胡素玲, 栗红江   

  1. 071000 河北 保定市传染病医院功能科(胡素玲),肝六科(栗红江)
  • 收稿日期:2019-11-03 出版日期:2020-08-31 发布日期:2020-09-04

The value of contrast-enhanced ultrasound with SonoVue in the differential diagnosis of atypical focal hepatic lesions

HU Su-ling, LI Hong-jiang   

  1. 1. Department of FunctionalSection Baoding Infectious Disease Hospital, HeBei 071000, China;
    2. Department of Hepatic six Baoding Infectious Disease Hospital, HeBei 071000, China
  • Received:2019-11-03 Online:2020-08-31 Published:2020-09-04

摘要: 目的 SonoVue超声造影对不典型肝脏局灶性病灶的鉴别诊断价值。方法 选取2016年3月至2019年3月期间我院接受CEUS检查的肝脏肿瘤患者64例,男性38例,女性26例,年龄(49.1±10.2)岁。经影像学检查(MRI和/或CT)或肝脏组织病理确诊76个不典型局灶性病灶,直径1.9 cm至7.6 cm之间,恶性55个(原发性肝细胞癌32个;原发性肝内胆管细胞癌6个;转移性肝癌17个),良性21个(肝血管瘤14个;局灶性结节增生5个;肝脓肿2个)。计量资料以(±s)表示,用t检验比较;计数资料以绝对值表示,用卡方检验比较。结果 超声造影表现中恶性不典型肝脏局灶性病灶[(17.2±3.3)s]开始增强时间明显短于良性局灶性病灶[(26.8±6.7)s,P<0.05];恶性不典型肝脏局灶性病灶[(77.8±12.7)s]开始消退时间明显短于良性局灶性病灶[(228.4±29.4)s,P<0.05];恶性不典型肝脏局灶性病灶[(43.6±9.3)s]开始消退时间明显少于良性局灶性病灶[(172.1±22.7)s,P<0.05]。原发性及转移性肝癌局灶性病灶在增强速度及消退速度例数比较中并无明显统计学差异(P>0.05),但在增强形式及增强强度的例数比较中有显著差异(P<0.05)。结论 基于SonoVue超声造影能够准确反映不典型肝脏局灶性病灶良恶性情况,并且可以对原发性或转移性肝癌病灶加以鉴别。

关键词: 肝脏局灶性病灶, 超声造影, SonoVue, 原发性肝癌, 转移性肝癌

Abstract: Objective To assess the value of contrast-enhanced ultrasound (CEUS) with SonoVue in the diagnosis of atypical focal hepatic lesions. Methods A total of 64 patients with liver tumors examined by CEUS using SonoVue in our hospital from March 2016 to March 2019 were selected, including 38 males and 26 females, with an average age of (49.1 ± 10.2) years. A total of 76 atypical focal lesions were diagnosed by imaging examination (MRI and/or CT) or liver histopathology, including 55 malignant lesions (32 primary hepatocellular carcinomas, 6 primary intrahepatic cholangiocarcinomas and 17 metastatic liver cancers) and 21 benign lesions (14 hepatic hemangiomas, 5 focal nodular hyperplasias and 2 hepatic abscesses), with the diameter ranging from 1.9 cm to 7.6 cm. The measurement data were expressed as (±s), compared by t test, and the count data were expressed as absolute values and compared by chi-square test. Results In CEUS, the initial enhancement time of malignant atypical liver focal lesions [(17.2 ± 3.3) s] was significantly earlier than that of benign focal lesions [(26.8 ± 6.7) s, P<0.05]. The initial enhancement washout time of malignant focal lesions [(77.8 ± 12.7) s] was significantly earlier than that of benign focal lesions [(228.4 ± 29.4) s, P<0.05]. The enhancement duration of malignant focal lesions [(43.6 ± 9.3) s] was significantly shorter than that of benign focal lesions [(172.1 ± 22.7) s, P<0.05]. There was no significant difference in the enhancement rate or washout rate between primary and metastatic liver cancers (P>0.05), but there was significant difference in the enhancement pattern and degree (P<0.05). Conclusion CEUS with SonoVue can accurately distinguish the malignant from benign atypical focal hepatic lesions, and primary from metastatic liver cancers.

Key words: Focal hepatic lesion, Contrast-enhanced ultrasound, SonoVue, Primary liver cancer, Metastatic liver cancer