超声造影对肝细胞癌合并门静脉血栓的诊断价值分析

肝脏 ›› 2021, Vol. 26 ›› Issue (10): 1099-1102.

超声造影对肝细胞癌合并门静脉血栓的诊断价值分析

刘佳, 郝丽君, 姜纬, 王珍琦

215002 南京医科大学附属苏州医院/苏州市立医院超声科(刘佳,姜纬,王珍琦);苏州大学附属第二医院超声科(郝丽君)

收稿日期:2020-11-26 出版日期:2021-10-31 发布日期:2021-12-07
通讯作者: 王珍琦,Email:147560805@qq.com
基金资助:
苏州市科技发展计划基金项目(SYSD2019187,SYSD2018242)

Analysis on the value of contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma with portal vein thrombosis

LIU Jia¹, HAO Li-jun², JIANG Wei¹, WANG Zhen-qi¹

1. Department of Ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University/Suzhou Municipal Hospital, Jiangsu 215002, China;
2. Department of Ultrasound, Second Affiliated Hospital of Soochow University, Jiangsu 215004, China

Received:2020-11-26 Online:2021-10-31 Published:2021-12-07
Contact: WANG Zhen-qi,Email:147560805@qq.com

摘要/Abstract

摘要： 目的评价超声造影(CEUS)对肝细胞癌(HCC)患者门静脉血栓(PVT)的诊断价值。方法 2015年1月至2020年9月苏州市立医院收治的HCC并发门静脉血栓患者52例。52例患者中恶性PVT 38例(恶性PVT组),良性PVT 14例(良性PVT组)。比较两组患者的临床资料和CEUS资料。计量资料比较采用t检验或Kruskal-Wallis H检验;计数资料比较采用卡方检验。结果恶性、良性PVT组年龄为(58.0±9.2)岁、(63.1±5.2)岁,PVT组AFP为176.4(13.8,2150.4)ng/dl、4.8(2.2,146.8)ng/dl,HCC病灶直径为(8.8±4.6)cm、(5.2±4.7)cm,差异均有统计学意义(t=-12.745,P<0.05);而两组患者Child-Pugh评分、HCC病灶数量及HCC病灶位置差异无统计学意义(P>0.05)。恶性、良性PVT组达峰时间为(48.3±25.8)s、(80.6±52.4)s,差异有统计学意义(t=17.540,P<0.05),峰值强度为(17.4±5.0)dB、(12.5±5.1)dB,差异有统计学意义(t=-11.745,P<0.05);AUC为(2130.8±721.6)dB/s、(1114.3±816.7)dB/s,差异有统计学意义(t=-18.005,P<0.05);上升时间为(16.6±8.4)s、(8.6±6.4)s,差异有统计学意义(t=-21.126,P<0.05);动脉期增强为36例(94.7%)、8例(19.5%),差异有统计学意义(χ²=-11.107,P<0.05);延迟期廓清为32例(84.2%)、1例(7.1%),差异有统计学意义(χ²=-26.205,P<0.05)。CEUS诊断恶性PVT敏感度为89.5%、特异度为100%和准确度为92.3%。结论 CEUS可用于HCC患者门静脉血栓的鉴别诊断。

关键词: 肝细胞癌, 超声造影, 门静脉血栓

Abstract: Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in hepatocellular carcinoma (HCC) patients with portal vein thrombosis (PVT). Methods Fifty-two HCC patients combined with PVT (35 males and 17 females) admitted to our hospital from January 2015 to September 2020 were retrospected, with an average age of (59.5 ± 8.6) years old. Thirty-eight were malignant PVT (malignant PVT group), including 32 males and 6 females, 14 were benign PVT (benign PVT group), including 9 males and 5 females. Measurement data were analyzed by t-test or Kruskal-Wallis H test; counting data were analyzed by chi-square test. Results The ages of malignant PVT group and benign PVT group were 58.0 ± 9.2 years and 63.1 ± 5.2 years, respectively, with statistical significance (t=4.104, P<0.05). The AFP levels of the 2 groups were 176.4 (13.8, 2150.4) ng/dl and 4.8 (2.2, 146.8) ng/dl, respectively, with statistical significance (Z=-40.146, P<0.05). The diameters of HCC lesions of the 2 groups were (8.8 ± 4.6) cm and (5.2 ± 4.7) cm, with statistical significance (t=-12.745, P<0.05). However, there was no significant difference in Child-Pugh score, number and location of HCC lesions between the two groups (P>0.05). The times to peak of the 2 groups were (48.3 ± 25.8) s and (80.6 ± 52.4) s, with statistical significance (t=17.540, P<0.05). The peak intensities of the 2 groups were (17.4 ± 5.0) dB and (12.5 ± 5.1) dB, with statistical significance (t=-11.745, P<0.05). The area under the curve (AUC) of the 2 groups were (2130.8 ± 721.6) dB/s and (1114.3 ± 816.7) dB/s, with statistical significance (t=-18.005, P<0.05). The rising times of the 2 groups were (16.6 ± 8.4) s and (8.6 ± 6.4) s, with statistical significance (t=-21.126, P < 0.05). The enhancement on arterial phase of the 2 groups were 36 cases (94.7%) and 8 cases (19.5%), with statistical significance (χ²=-11.107, P<0.05). The wash-out on delay phase of the 2 groups were 32 cases (84.2%) and 1 case (7.1%), with statistical significance (χ²=-26.205, P<0.05). The sensitivity, specificity and accuracy of CEUS in diagnosing malignant PVT were 89.5% (34/38), 100% (14/14) and 92.3% (48/52), respectively. Conclusion CEUS performs well in the differential diagnosis of PVT in HCC patients, which is worth promoting clinically.

Key words: Hepatocellular carcinoma, Contrast-enhanced ultrasound, Portal vein thrombosis

刘佳, 郝丽君, 姜纬, 王珍琦. 超声造影对肝细胞癌合并门静脉血栓的诊断价值分析[J]. 肝脏, 2021, 26(10): 1099-1102.

LIU Jia, HAO Li-jun, JIANG Wei, WANG Zhen-qi. Analysis on the value of contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma with portal vein thrombosis[J]. Chinese Hepatolgy, 2021, 26(10): 1099-1102.

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