| 摘要: |
| 目的：研究超声造影（CEUS）对慢性肝病患者≤3cm肝细胞肝癌（HCC）的诊断价值。
方法：回顾性分析我院行CEUS检查的慢性肝病患者的252个肝脏局灶性病变的影像学和临床资料，评估CEUS对≤3cmHCC的诊断价值。
结果：≤3cmHCC主要表现为高-等-低增强（38.95%，37/95）、高-低-低增强（29.47%，28/95）的典型增强模式，28.42% (27/95)呈不典型增强模式。典型增强模式在＞2cm组占比高于≤2cm组，不典型增强模式在＞2cm组占比低于≤2cm组，差异有统计学意义（均P＜0.05）。典型增强模式对≤3cm HCC的诊断准确性、敏感性分别为84.52%、65.26%，AUC为0.807，结合患者为HCC高危人群且将不典型增强模式也做为≤3cmHCC的诊断标准，其准确性、敏感性分别为93.65%、93.68%，AUC 为0.937，差异有统计学意义（均P＜0.05）。
结论：≤3cmHCC超声造影表现可不典型，且病灶越小不典型增强模式比例越高。结合患者为HCC高危人群，联合典型、不典型增强模式进行综合判断，可提高CEUS对≤3cmHCC的诊断效能。 |
| 关键词: 肝 肝细胞肝癌 肝脏局灶性病变 超声造影 |
| DOI： |
| 投稿时间：2023-03-23修订日期：2023-08-12 |
| 基金项目: |
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| Value of contrast-enhanced ultrasound for hepatocellular carcinoma less than 3cm in patients with chronic liver disease |
| ZHENG Li-li,REN Xin-ping,ZHAN Wei-wei,FENG Mei-jing,LI Jun-jian,ZHANG Jie |
| (Department of Ultrasound,Wuxi Xinwu District Xinrui Hospital;Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine) |
| Abstract: |
| Objective: To research the diagnostic value of contrast-enhanced ultrasound for hepatocellular carcinoma (diameter ≤3cm) in patients with chronic liver disease.
Methods: Imaging and clinical data of 252 focal liver lesions in patients with chronic liver disease who underwent CEUS examination in our hospital were retrospectively analyzed to evaluating the diagnostic value of CEUS for HCCs ≤3cm.
Results: The typical enhancement patterns of hyper – iso – hypo and hyper - hypo – hypo were revealed in 37/95(38.95%) and 28/95(29.47%),and the atypical enhancement patterns were revealed in 27/95(28.42%) in HCCs ≤3cm . HCCs＞2cm displayed a higher proportion of typical enhancement pattern and a lower proportion of atypical enhancement pattern compared with that of HCCs ≤ 2cm (both P < 0.05). The accuracies were 84.52% and 93.65%, the sensitivities were 65.26% and 93.68%, and the AUCs were 0.807 and 0.937,respectively (all P < 0.05), when typical CEUS enhancement pattern was considered to be diagnostic criteria for HCCs and atypical enhancement combing with the high risk of hepatocellular carcinoma was also assuming to be indicative of HCCs.
Conclusions: Atypical contrast-enhanced ultrasound features may appear in HCCs ≤3cm , and the smaller the lesion, the higher the proportion. The diagnostic efficacy of CEUS for HCCs ≤3cm can be improved by combining the high-risk of hepatocellular carcinoma , typical and atypical enhancement patterns. |
| Key words: Liver Hepatocellular carcinoma Focal liver lesion Contrast-enhanced ultrasound |
