肝细胞癌与肝内胆管癌超声表现和超声造影增强特点分析*

doi:10.3969/j.issn.1672-5069.2025.04.030

摘要/Abstract

摘要： 目的探讨肝细胞癌(HCC)与肝内胆管癌(ICC)超声和超声造影(CEUS)检查表现,以帮助临床鉴别诊断。方法 2019年3月～2024年5月我院诊治的HCC患者86例和ICC患者16例,均行超声和CEUS检查,比较两组病变超声特征和CEUS增强特点。结果常规超声检查,两组肝内占位病变数目、形态、肿瘤直径、内部回声、回声特点和门静脉癌栓占比比较,差异无统计学意义(P＞0.05),ICC组胆管扩张占比为37.5%,显著高于HCC组的2.3%(P＜0.05);CEUS显示,ICC病灶动脉期呈环形增强、动脉期低增强、门脉期低增强和延迟期病灶廓清时间分别为37.5%、18.8%、93.8%和(45.2±8.1)s,均显著高于或短于HCC病灶【分别为10.5%、2.3%、59.3%和(66.7±11.8)s,P＜0.05】。结论使用超声和CEUS检查,注意发现是否存在胆管扩张、动脉期强化方式、动脉期强化特点和廓清时间将有助于鉴别HCC与ICC诊断。

关键词: 肝细胞癌, 肝内胆管癌, 超声造影, 诊断

Abstract: Objective The aim of this study was to compare conventional and contrast-enhanced ultrasonography (CEUS) features of hepatocellular carcinoma (HCC0 and intrahepatic cholangiocarcinoma(ICC) for differentiation of the two entities. Methods 86 patients with HCC and 16 patients with ICC were encountered in our hospital between March 2019 and May 2024, and all underwent conventional and contrast-enhanced ultrasonography. The imaging features were compared between the two malignant tumors. Results There were no significant differences as respect to numbers of intrahepatic space-occupying lesions, shapes, diameters, intratumor echos, echo features and portal thrombosis between the two groups (P＞0.05), while the percentage of bile duct dilatation in patients with ICC was 37.5%, much higher than 2.3%(P＜0.05)in those with HCC; CEUS demonstrated that percentages of arterial-phase ring enhancement, arterial-phase hypo-enhancement, portal-phase hypo-enhancement andclearing time at delayed phase in ICC group were 37.5%, 18.8%, 93.8% and (45.2±8.1)s, all significantly higher or shorter than 10.5%, 2.3%,59.3% and (66.7±11.8)s in HCC group (P＜0.05). Conclusion The imaging features, such as bile duct dilation, arterial phase enhancement mode, arterial phase enhancement characteristics, and significant differences in clearance time in patients with ICC and HCC are obvious different, which might help clinicians differentiate the two liver cancers.

Key words: Hepatocellular carcinoma, Intrahepatic cholangiocarcinoma, Contrast-enhanced ultrasound, Diagnosis

李慧慧, 姚晓松, 肖征, 陈念. 肝细胞癌与肝内胆管癌超声表现和超声造影增强特点分析^*[J]. 实用肝脏病杂志, 2025, 28(4): 597-600.

Li Huihui, Yao Xiaosong, Xiao Zheng, et al. Comparison of conventional and contrast-enhanced ultrasonography features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: What's the differences?[J]. Journal of Practical Hepatology, 2025, 28(4): 597-600.

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肝细胞癌与肝内胆管癌超声表现和超声造影增强特点分析^*

Comparison of conventional and contrast-enhanced ultrasonography features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: What's the differences?

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