CEUS动脉期诊断肝硬化背景下微小肝细胞癌与病理结果的一致性分析

肝脏 ›› 2023, Vol. 28 ›› Issue (2): 200-202.

CEUS动脉期诊断肝硬化背景下微小肝细胞癌与病理结果的一致性分析

尹伟, 冯玉成, 罗嵩智, 戴圣道

410004 湖南长沙市第三医院超声科

收稿日期:2022-04-21 出版日期:2023-02-28 发布日期:2023-04-10
通讯作者: 戴圣道,Email:dsdxsyx@163.com
基金资助:
长沙市科技计划项目(kq1801123)

An analysis on the consistency between arterial phase diagnosis of contrast-enhanced ultrasound and pathological results of micro-hepatocellular carcinoma in the context of liver cirrhosis

YIN Wei, FENG Yu-cheng, LUO Song-zhi, DAI Sheng-dao

Department of Ultrasound, Changsha Third Hospital, Hunan 410004, China

Received:2022-04-21 Online:2023-02-28 Published:2023-04-10
Contact: DAI Sheng-dao,Email:dsdxsyx@126.com

摘要/Abstract

摘要： 目的研究超声造影(CEUS)动脉期诊断肝硬化背景下微小肝细胞癌的价值。方法纳入2016年8月—2021年8月长沙市第三医院收治的肝结节患者66例(共70个结节)为研究对象,所有患者均存在肝硬化背景。患者均经病理检查明确病变性质,并据此分为微小肝癌组(38例、40个结节)和非恶变结节组(28例、30个结节)。病理诊断前,患者均行CEUS检查,观察各病灶CEUS增强灌注模式及增强峰值、降支减半及持续增强时间,分析CEUS诊断肝硬化背景下微小肝细胞癌与病理结果的一致性。结果微小肝癌组所有患者动脉相造影均呈现高增强,而门脉相则多为低增强(32/40,80.00%);非恶变组病灶动脉相以低增强为主(17/30,56.67%),门脉相以等增强为主(22/30,73.33%)。两组病灶在动脉相和门脉相的增强水平有显著差异(P<0.05)。微小肝癌组降支减半时间(84.68±18.20)s、增强峰值时间(22.65±8.84)s、持续增强时间(41.03±10.81)s均显著低于非恶变组[(115.03±20.12)s、(30.59±10.75)s、(84.54±18.20)s](P<0.05)。CEUS诊断肝硬化后微小肝细胞癌的灵敏度为92.50%,特异度为80.00%,准确率为87.14%,阳性预测值为86.05%,阴性预测值为88.89%,Kappa值为0.734。结论肝硬化背景下微小肝细胞癌与肝硬化结节有不同的CEUS灌注特点,CEUS对早期诊断肝硬化合并微小肝癌具有重要价值。

关键词: 超声造影, 动脉期, 诊断, 肝硬化, 微小肝细胞癌

Abstract: Objective To analysis the significance of the arterial phase contrast-enhanced ultrasound (CEUS) in the diagnosis of micro-hepatocellular carcinoma in the context of liver cirrhosis. Methods 66 patients with liver nodules (totally 70 nodules) were included in the study from August 2016 to August 2021. All patients had background of liver cirrhosis. The nature of the lesions was confirmed by pathological examination, and the patients were divided into micro-liver cancer group (38 cases, 40 nodules) and non-malignant nodule group (28 cases, 30 nodules). Before pathological diagnosis, all patients underwent CEUS examination. The CEUS enhanced perfusion mode, descending branch halving time, enhancement peak time and continuous enhancement time of each lesion were observed, and the consistency between CEUS diagnosis of micro-hepatocellular carcinoma under the background of liver cirrhosis and pathological results was analyzed. Results The arterial phase of all lesions in micro-liver cancer group was high enhancement, and the portal vein phase was mainly low enhancement (32/40, 80.00%); In the non-malignant group, the arterial phase was mainly low enhancement (17/30, 56.67%), and the portal phase was mainly equal enhancement (22/30, 73.33%). The enhancement levels of arterial phase and portal vein phase between the two groups was significantly differenct (P<0.05). The descending branch halving time (84.68±18.20)s, peak enhancement time (22.65±8.84)s and continuous enhancement time (41.03±10.81)s in the micro- hepatocellular carcinoma group were lower than those in the non-malignant group [(115.03 ± 20.12)s, (30.59 ± 10.75)s, (84.54 ± 18.20)s] (P<0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa value of CEUS were 92.50%, 80.00%, 87.14%, 86.05%, 88.89% and 0.734 respectively. Conclusion The perfusion of minuscule liver nodules in the early stage of hepatocellular carcinoma is different from that of liver cirrhosis. CEUS has important value in the diagnosis of micro-liver cancer complicated with liver cirrhosis.

Key words: Contrast-enhanced ultrasound, Arterial phase, Diagnosis, Cirrhosis, Micro-hepatocellular carcinoma

尹伟, 冯玉成, 罗嵩智, 戴圣道. CEUS动脉期诊断肝硬化背景下微小肝细胞癌与病理结果的一致性分析[J]. 肝脏, 2023, 28(2): 200-202.

YIN Wei, FENG Yu-cheng, LUO Song-zhi, DAI Sheng-dao. An analysis on the consistency between arterial phase diagnosis of contrast-enhanced ultrasound and pathological results of micro-hepatocellular carcinoma in the context of liver cirrhosis[J]. Chinese Hepatolgy, 2023, 28(2): 200-202.

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