超声造影成像特征及定量参数鉴别肝脏炎性假瘤与肝内胆管细胞癌的价值

肝脏 ›› 2022, Vol. 27 ›› Issue (3): 292-295.

超声造影成像特征及定量参数鉴别肝脏炎性假瘤与肝内胆管细胞癌的价值

朱婷, 林立平, 韦玉亚

518052 广东华中科技大学协和深圳医院超声医学科(朱婷,韦玉亚) ; 中山大学附属第八医院超声医学科(林立平)

收稿日期:2021-11-29 出版日期:2022-03-31 发布日期:2022-05-31
基金资助:
深圳市科技计划项目(JCYJ20180302144649363)

Clinical value of imaging features and quantitative parameters of CEUS in differentiating hepatic inflammatory pseudotumor from intrahepatic cholangiocarcinoma

ZHU Ting¹, LIN Li-ping², WEI Yu-ya¹

1. Department of Ultrasound Medicine, Union Shenzhen Hospital, Huazhong University of Science and Technology,Guangdong 518052, China;
2. Department of Ultrasound Medicine,the Eighth Affiliated Hospital of Sun Yat-sen University, Guangdong 518000,China

Received:2021-11-29 Online:2022-03-31 Published:2022-05-31

摘要/Abstract

摘要： 目的探讨超声造影(CEUS)成像特征及定量参数对肝脏炎性假瘤(IPT)与肝内胆管细胞癌(ICC)的鉴别价值。方法选取华中科技大学协和深圳医院和中山大学附属第八医院在2016年4月—2021年7月ICC患者57例设为ICC组,另选IPT患者32例为IPT组,大部分患者均经手术或穿刺活检病理证实。两组均于入院时行常规超声和CEUS检查,观察两组CEUS成像特征(动态增强模式、动脉期增强方式、动脉期增强程度)及定量参数(开始增强时间、达峰时间、等增强时间、开始消退时间),借助ROC分析达峰时间、等增强时间、开始消退时间对ICC的预测价值。结果 ICC组“快进快退”的患者占比为35.09%,显著低于IPT组的68.75%(P<0.05),ICC组周边环状增强、整体不均匀增强、整体均匀增强患者占比分别为31.58%、54.39%、14.04%,IPT组分别为18.75%、40.63%、40.63%,两组比较差异有统计学意义(P<0.05)。ICC组达峰时间、等回声时间、开始消退时间分别为(26.56±6.53)、(33.53±7.25)、(48.12±9.12)s,显著高于IPT组的(22.93±7.26)、(27.53±7.46)、(41.75±9.55)s,两组比较差异有统计学意义(P<0.05)。经ROC分析,达峰时间、等增强时间、开始消退时间预测ICC的曲线下面积分别为0.877、0.925、0.924,差异均有统计学意义(P<0.05)。结论 CEUS成像特征及定量参数对ICC和IPT具有一定鉴别价值。

关键词: 超声造影, 肝脏炎性假瘤, 肝内胆管细胞癌, 定量参数

Abstract: Objective To investigate the value of imaging characteristics and quantitative parameters of contrast-enhanced ultrasound (CEUS) in differentiating hepatic inflammatory pseudotumor (IPT) from intrahepatic cholangiocarcinoma (ICC).Methods Fifty-seven patients with ICC admitted to our hospital from April 2016 to July 2021 were selected into ICC group, and 32 patients with IPT were selected into IPT group. Most patients were confirmed by surgery or needle biopsy. All patients underwent CEUS examination at admission. Imaging features (dynamic enhancement mode, enhancement mode in arterial phase, enhancement degree in arterial phase) and quantitative parameters (arrival time of contrast agent, peak time, iso-enhancement time, start fading time) of CEUS were observed in 2 groups. Receiver operator characteristic (ROC) curve was used to analyze the value of peak time, iso-enhancement time and fading time in predicting ICC.Results The CEUS pattern of 35.09% patients in ICC group was swift enhancement and simultaneous expurgation, significantly lower than that in IPT group (68.75%), (P<0.05). The proportions of peripheral ring enhancement, heterogeneous enhancement and homogeneous enhancement in ICC group were 31.58%, 54.39% and 14.04%, respectively, and those in IPT group were 18.75%, 40.63% and 40.63%, respectively, the differences were statistically significant (P<0.05). The peak time, iso-enhancement time and fading time of ICC group were 26.56 ± 6.53, 33.53 ± 7.25, 48.12 ± 9.12s respectively, which were significantly higher than those of IPT group (22.93 ± 7.26, 27.53 ± 7.46, 41.75 ± 9.55s), and the differences were statistically significant (P<0.05). According to ROC analysis, the area under curve of peak time, iso-enhancement time and fading time in predicting ICC were 0.877, 0.925 and 0.924, respectively, with P<0.05.Conclusion Imaging features and quantitative parameters of CEUS have a certain value in differentiating ICC from IPT.

Key words: Contrast-enhanced ultrasound, Inflammatory pseudotumor of liver, Intrahepatic cholangiocarcinoma, Quantitative parameters

朱婷, 林立平, 韦玉亚. 超声造影成像特征及定量参数鉴别肝脏炎性假瘤与肝内胆管细胞癌的价值[J]. 肝脏, 2022, 27(3): 292-295.

ZHU Ting, LIN Li-ping, WEI Yu-ya. Clinical value of imaging features and quantitative parameters of CEUS in differentiating hepatic inflammatory pseudotumor from intrahepatic cholangiocarcinoma[J]. Chinese Hepatolgy, 2022, 27(3): 292-295.

参考文献

[1] Yoo J, Lee JM. Diagnostic Value of High Frame Rate Contrast-enhanced Ultrasonography and Post-processing Contrast Vector Imaging for Evaluation of Focal Liver Lesions: A Feasibility Study. Ultrasound Med Biol,2020, 46:2254-2264.
[2] 陈磊杰, 杨春凤, 张丽. 螺旋CT对肝脏炎性假瘤,原发性肝癌的诊断价值. 数理医药学杂志,2020,33:1655-1657.
[3] Schaible J, Stroszczynski C, Beyer LP, et al. Quantitative perfusion analysis of hepatocellular carcinoma using dynamic contrast enhanced ultrasound (CEUS) to determine tumor microvascularization. Clin Hemorheol Microcirc, 2019,73:95-104.
[4] 徐伟. 肝脏增生性瘤样病变诊疗研究进展. 现代医药卫生, 2018,34:2667-2670.
[5] 郝艳红, 陈武, 陈敏华. 肝内胆管细胞癌常规超声及超声造影诊断的临床应用. 山西医药杂志, 2018, 47:517-520.
[6] Ozturk M, Selcuk MB, Polat AV, et al. The diagnostic value of ultrasound and shear wave elastography in the differentiation of benign and malignant soft tissue tumors. Skeletal Radiol. 2020,49:1795-1805.
[7] Li R, Wu G, Wang R . Application values of 3.0T magnetic resonance diffusion weighted imaging for distinguishing liver malignant tumors and benign lesions. Oncol Lett, 2018, 15:2091-2096.
[8] Pitcairn C, Kawka M. Contrast-enhanced ultrasonography for intrahepatic cholangiocarcinoma: A cost-effective alternative for low-resource settings. Hepatobiliary Pancreat Dis Int, 2021, 20:304-305.
[9] 武晓静, 丹海俊, 孙丽,等. 肝内胆管细胞癌患者超声造影表现特征分析. 实用肝脏病杂志, 2018, 21:803-804.
[10] Schellhaas B, Bernatik T, Bohle W, et al. Contrast-Enhanced Ultrasound Algorithms (CEUS-LIRADS/ESCULAP) for the Noninvasive Diagnosis of Hepatocellular Carcinoma-A Prospective Multicenter DEGUM Study. Ultraschall Med, 2021, 42:178-186.
[11] 李敏,红华,王芳,等. 超声造影技术在单发转移性肝癌与肝炎性假瘤鉴别诊断中的价值.内蒙古医学杂志,2019,51:259-261.
[12] 于福盈, 王春光, 辛旺,等. 超声造影联合血清学检测诊断肝脏良恶性肿瘤. 肝脏, 2019, 24:172-174.
[13] 唐静, 王飞. 超声造影诊断肝内肿块性质的临床价值分析. 中国肿瘤外科杂志, 2018, 10:50-51.
[14] 鲍昌初. 肝硬化背景下超声造影对肝内微小结节的诊断价值分析. 中国继续医学教育, 2018,10:75-76.
[15] 薛海燕,孔文韬,沈海云,等. 超声造影在肝内胆管癌与肝脏炎性假瘤鉴别诊断中的应用. 肿瘤影像学, 2020, 29:67-72.