超声造影对肝细胞癌与肝转移癌的鉴别诊断价值分析

doi:10.3969/j.issn.1672-5069.2020.01.026

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (1): 94-97.doi: 10.3969/j.issn.1672-5069.2020.01.026

超声造影对肝细胞癌与肝转移癌的鉴别诊断价值分析

刘潇, 何年安, 叶显俊, 刘力, 付文学, 陈姣姣

230001 合肥市中国科学技术大学附属第一医院(安徽省立医院)超声医学科

收稿日期:2019-06-20 出版日期:2020-01-10 发布日期:2020-01-14
通讯作者: 何年安,E-mail:henianan71@qq.com
作者简介:刘潇,男,30岁,医学硕士。主要从事超声造影与介入诊断研究。E-mail:784365261@qq.com

Application of contrast-enhanced ultrasound in differential diagnosis of hepatocellular carcinoma and liver metastases

Liu Xiao, He Nian’an, Ye Xianjun, et al

Department of Ultrasound,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui,230001,China

Received:2019-06-20 Online:2020-01-10 Published:2020-01-14

摘要/Abstract

摘要： 目的研究超声造影(CEUS)检查肝转移癌(LM)与肝细胞癌(HCC)的表现特征和鉴别诊断价值。方法 2016年～2019年就诊于我院的肝脏占位患者117例,常规行CEUS检查,分析比较HCC与LM病灶在增强模式、开始增强时间、达峰时间和减退时间等方面的异同。结果在77例HCC 患者中,有79个病灶,在40例LM患者中,有41个病灶;HCC病灶呈I型增强为2.5%,II型为26.6%,III型为70.9%,而LM病灶分别为36.6%、9.8%和53.7%,差异显著(P＜0.05);HCC病灶增强达峰时间和减退时间分别为(29.16±7.87)s和(51.89±22.80)s,与LM病灶的【(25.98±5.30)s和(37.49±10.68)s,P＜0.05 】。结论 HCC与LM病灶在CEUS表现有一定的差异,对鉴别诊断具有很大的价值。

关键词: 肝细胞癌, 肝转移癌, 超声造影, 诊断

Abstract: Objective The purpose of this study was to investigate the application of contrast-enhanced ultrasound (CEUS) in differential diagnosis of hepatocellular carcinoma (HCC) and liver metastases (LM). Methods 77 patients with HCC (79 foci) and 40 patients with LM (41 foci) were recruited in our hospital, and routine sonography and CEUS were conducted. Results The enhancement type I, type II and type III in patients with HCC were 2.5%, 26.6% and 70.9%, significantly different as compared to 36.6%, 9.8% and 53.7%, respectively, in patients with LM (P＜0.05); the peak time of enhancement and the time of washing out in HCC foci were (29.16±7.87)s and (51.89±22.80)s, significantly different as compared to 【(25.98±5.30) and (37.49±10.68)s, respectively, P＜0.05 】 in LM foci. Conclusion The performance of CEUS in differentiating HCC and LM foci is efficacious, which might be helpful in clinical practice.

Key words: Hepatocellular carcinoma, Liver metastasis, Contrast enhanced ultrasound, Diagnosis

刘潇, 何年安, 叶显俊, 刘力, 付文学, 陈姣姣. 超声造影对肝细胞癌与肝转移癌的鉴别诊断价值分析[J]. 实用肝脏病杂志, 2020, 23(1): 94-97.

Liu Xiao, He Nian’an, Ye Xianjun, et al. Application of contrast-enhanced ultrasound in differential diagnosis of hepatocellular carcinoma and liver metastases[J]. Journal of Practical Hepatology, 2020, 23(1): 94-97.

参考文献

[1] Torre LA, Bray F, Siegel RL, et al. Global cancer statistics,2012. CA Cancer J Clin,2015,65(2):87-108.
[2] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China,2015. CA:A Cancer J Clin,2016,66(2):115-132.
[3] Omata M, Cheng AL, Kokudo N, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int, 2017, 11(4): 317370.
[4] Quaia E, Bertolotto M, Forgaces B, et al. Detection of liver metastases by pulse inversion harmonic imaging during Levovist late phase: comparison with conventional ultrasound and helical CT in 160 patients. Eur Radiol, 2003, 13(3):475-483.
[5] Jang HJ, Kim T, Burns PN, et al. CEUS:an essential component in a multimodality approach to small nodules in patients at high-risk for hepatocellular carcinoma. Eur J Radiol,2015,84(9):1623-1635.
[6] 乔志忠. 超声造影定量分析鉴别肝脏局灶性结节性增生与原发性肝癌初步探讨.实用肝脏病杂志,2019,22(3):421-424.
[7] 尹珊珊,陈敏华,严昆,等. 超声造影对肝转移癌的诊断价值.中华超声影像学杂志,2005,14(5):354-358.
[8] 李颖嘉,文戈,吴凤林. 超声造影定量分析对乳腺良恶性肿瘤区域血流动力学灌注特征的研究.生物医学工程与临床,2009,13(5):431-435.
[9] Albrecht T, Holumnn J, Oldenburg A, et al. Detection and characterisation of liver metastases. Eur Radiol,2004,14(8):25-33.
[10] Ogawa S, Kumada T, Toyoda H. Evaluation of pathological features of hepatocellular carcinoma by contrast-enhanced ultrasonography: comparison with pathology on resected specimen. Eur J Radiol,2006,59(1):74-81.
[11] Wang YC, Chou CT, Lin CP, et al. The value of Gd-EOB-DTPA enhanced MR imaging in characterizing cirrhotic nodules with atypical enhancement on Gd-DTPA-enhanced MR images. PLoS One, 2017, 12(3):e0174594.
[12] Ling W, Wang M, Ma X, et al. The preliminary application of liver imaging reporting and data system (LI-RADS) with contrast-enhanced ultrasound (CEUS) on small hepatic nodules (≤ 2 cm). J Cancer, 2018, 9(16): 2946-2952.
[13] He Y, Liu F, Mou S, et al. Prognostic analysis of hepatocellular carcinoma on the background of liver cirrhosis via contrast enhanced ultrasound and pathology. Oncol Lett,2018,15(3): 3746-3752.
[14] Facciorusso A, Licinio R, Muscatiello N, et al. Transarterial chemoembolization: evidences from the literature and applications in hepatocellular carcinoma patients. World J Hepatol, 2015, 7(16): 2009-2019.
[15] Ikemoto T, Shimada M, Yamada S. Pathophysiology of recurrent hepatocellular carcinoma after radiofrequency ablation. Hepatol Res,2017,47(1):23-30.
[16] Kim TK,Jang HJ. Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis. World J Gastroenterol,2014,20(13):3590-3596.
[17] 郭振宁. 超声造影诊断微小原发性肝癌患者临床价值研究.实用肝脏病杂志,2018,21(5):741-744.
[18] Yang D, Li R, Zhang XH, et al. Perfusion characteristics of hepatocellular carcinoma at contrast-enhanced ultrasound: influence of the cellular differentiation, the tumor size and the underlying hepatic condition. Sci Rep,2018,8(1) :4713.
[19] Kazuhiro K, Yoichiro K, Masahiko H, et al. Ring enhancement on T1-weighted GRE images after ferucarbotran administration for hepatic metastasis: comparison with pathological findings: case report. Radiat Med,2005,23(1): 75-79.
[20] 韩峰,邹如海,裴小青,等. 超声造影定量分析鉴别富血供转移性肝癌与肝细胞癌.中国医学影像技术,2011,27(10):2079-2082.
[21] Kong ET, JI ZB, Wang WP, et al. Evaluation of liver metastases using contrast-enhanced ultrasound:enhancement patterns and influencing factors. Gut Liver,2016,10(2):283-287.

超声造影对肝细胞癌与肝转移癌的鉴别诊断价值分析

Application of contrast-enhanced ultrasound in differential diagnosis of hepatocellular carcinoma and liver metastases

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	杨可芷, 陆伟, 黄丹, 李秀芬, 王雁冰, 周新兰, 丁蓉蓉, 张占卿. γ-谷氨酰转肽酶/胆碱酯酶比值预测慢性乙型肝炎患者肝纤维化程度的效能评价^*[J]. 实用肝脏病杂志, 2020, 23(1): 14-17.
[2]	叶细容, 吕志红, 江峰, 解育新. 两种超声弹性成像技术诊断慢性乙型肝炎患者肝纤维化价值比较^*[J]. 实用肝脏病杂志, 2020, 23(1): 18-21.
[3]	陈丽丽, 符茂雄, 蒙绪标, 方其超. 空腹C肽评估NAFLD合并T2DM患者肝纤维化进展价值分析^*[J]. 实用肝脏病杂志, 2020, 23(1): 38-41.
[4]	柳健, 朱峰发, 唐娟. 非均匀性脂肪肝患者腹部超声表现和血脂变化特点^*[J]. 实用肝脏病杂志, 2020, 23(1): 42-45.
[5]	王晶晶, 李春涛, 周卫真. 失代偿期乙型肝炎肝硬化患者尿液视黄醇结合蛋白水平及其临床意义探讨^*[J]. 实用肝脏病杂志, 2020, 23(1): 74-77.
[6]	石莹莹, 王元喜. 应用肝脏影像报告与数据管理系统诊断肝细胞癌的价值研究^*[J]. 实用肝脏病杂志, 2020, 23(1): 98-101.
[7]	马宁, 戴晓雯, 吴建江. 肝部分切除术患者目标导向性液体治疗疗效及安全性研究^*[J]. 实用肝脏病杂志, 2020, 23(1): 102-105.
[8]	高莉, 高屹, 尹秋萍. CT灌注成像联合彩色多普勒超声造影辨别肝脏结节性病变性质临床价值探讨^*[J]. 实用肝脏病杂志, 2020, 23(1): 106-109.
[9]	王秀清, 马燕君, 詹晋莉. 微泡性多囊肝影像学检查表现比较^*[J]. 实用肝脏病杂志, 2020, 23(1): 114-117.
[10]	王纯, 陈东风. Fitz-Hugh-Curtis综合征研究进展^*[J]. 实用肝脏病杂志, 2020, 23(1): 149-152.
[11]	陈慧婷, 周永健. 妊娠期肝内胆汁淤积症诊断与管理[J]. 实用肝脏病杂志, 2020, 23(1): 153-155.
[12]	中国研究型医院学会肝病专业委员会, 中国医师协会脂肪性肝病专家委员会. 脂肪性肝病诊疗规范化的专家建议（2019年修订版）[J]. 实用肝脏病杂志, 2019, 22(6): 787-792.
[13]	. 肝纤维化诊断及治疗共识（2019年）[J]. 实用肝脏病杂志, 2019, 22(6): 793-803.
[14]	吴海义, 陈建新. 四种诊断模型诊断乙型肝炎病毒携带者肝纤维化的效能分析^*[J]. 实用肝脏病杂志, 2019, 22(6): 832-835.
[15]	曹策, 郁义星, 王贝贝, 赵卫峰. 增强磁共振成像联合血清甲胎蛋白和脱-γ-羧基凝血酶原诊断肝细胞癌临床价值探讨[J]. 实用肝脏病杂志, 2019, 22(6): 896-899.