| 摘要: |
| 摘 要 目的 探讨肝硬化患者发现肝脏局灶性病变的超声造影特征。方法 回顾性分析经穿刺活检或手术病理证实的53例肝硬化背景下肝脏局灶性病变患者的超声造影表现，采用Fisher确切概率法比较不同分化程度（高分化和中-低分化）HCC的廓清时相和不同大小（≤3 cm、3~5 cm、≥5 cm）HCC的动脉相增强模式的差异。结果 10例肝硬化结节患者中7例与周围肝实质三期均呈等增强，2例动脉相呈低增强，门脉相和延迟相呈等增强，另1例动脉相和门脉相呈等增强，而延迟相呈低增强。1例胆管细胞癌动脉相出现周边不均匀增强，肿块中间增强不明显，门脉相开始廓清。不同分化程度的HCC在动脉相、门脉相、延迟相的廓清例数比较，差异有统计学意义（P＜0.05）。病灶直径≤3 cm与＞5 cm的HCC动脉相的增强模式比较，差异有统计学意义（P=0.01）。结论 不同分化程度的HCC廓清时相存在差异，不同大小的HCC动脉相的增强模式也存在差异，超声造影对于鉴别肝硬化背景下局灶性病变的良恶性具有较高特异性。 |
| 关键词: 超声检查 造影剂 肝硬化 局灶性病变 |
| DOI： |
| 投稿时间：2017-02-22修订日期：2017-04-16 |
| 基金项目: |
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| Contrast Enhanced Ultrasound Analysis of Focal Liver lesions with Cirrhosis |
| xu jian,mu xiaorong |
| () |
| Abstract: |
| ABSTRACT Objective To investigate the features of focal liver lesions with cirrhosis in contrast-enhanced ultrasound(CEUS). Methods The CEUS features of 53 cases of focal liver lesions with cirrhosis confirmed by aspiration biopsy or surgery were retrospectively enrolled．Fisher''s exact test was used to compare the washout phase differences of hepatocellular carcinoma（HCC） in different degree of differentiation.( high differentiation group and medium-low differentiation group ) and to compare the differences of enhancement patterns of HCC in arterial phase with different size（≤3 cm、3~5 cm、≥5 cm）. Results Among 10 cases of cirrhosis nodule， 7 cases presented iso-enhancing with the surrounding liver parenchyma in the three phases ; 2 cases presented hypo-enhancing in arterial phase and iso-enhancing in portal venous phase and delayed phase; the rest 1 case presented iso-enhancing in arterial phase and portal venous phase and hypo-enhancing in delayed phase. 1 case of cholangiocellular carcinoma presented heterogeneous peripheral enhancement and unconspicuous central enhancement in arterial phase ,and washout occurred in portal venous phase; The washout ratio of HCC in different degree of differentiation in arterial phase 、portal venous phase and late phase have statistical significance （P＜0.05）. There was statistical difference in enhancement patterns between the group（ the diameter≤3cmHCC）and the group（ the diameter≥5cm）（P=0.01＜0.05） . Conclusion There exist phase differences in the washout of hepatocellular carcinoma（HCC） in different degree of differentiation，and there also exist differences in enhancement patterns in arterial phase of HCC with different size. Contrast enhanced ultrasound possesses high specificity in distinguish focal liver lesions with cirrhosis between benign and malignant . |
| Key words: Ultrasonograph Contrast agent cirrhosis focal liver lesions |
