摘要
目的探讨超声造影诊断典型与非典型肝癌的声像学特征。方法选择行肝脏占位性病变超声造影患者148例,其中不符合欧洲超声造影剂指导原则中原发性肝癌典型表现的患者47例作为非典型肝癌组,符合原发性肝癌典型表现者80例作为典型肝癌组。所有病例经病理检查确诊,比较2组与病理检查结果的一致性和2组声像学的不同。结果超声造影与病理检测结果一致性比较,Kappa=0.784,两者诊断一致性较好。超声造影诊断典型肝癌的准确率为98.75%,诊断非典型肝癌的准确率为95.74%,两者差异无统计学意义(χ~2=0.847,P>0.05)。典型肝癌和非典型肝癌开始增强时间和持续时间比较,差异无统计学意义,P均>0.05。典型肝癌和非典型肝癌开始消退时间比较,差异具有统计学意义(P<0.05)。非典型肝癌组与典型肝癌组Ⅰ型高分化者(χ~2=0.554)、Ⅱ~Ⅲ型低分化者(χ~2=0.478)动脉期增强表现比较,差异无统计学意义,P均>0.05。门脉期,非典型肝癌组和典型肝癌组Ⅰ型高分化者表现为等回声的比例(χ~2=6.987)、Ⅱ~Ⅲ型(χ~2=6.014)比较,差异具有统计学意义,P均<0.05;非典型肝癌组与典型肝癌组Ⅰ型(χ~2=6.845)、Ⅱ~Ⅲ型(χ~2=5.995)的增强方式比较,P均<0.05,差异具有统计学意义。结论超声造影可敏感地反映肝肿瘤的血流动力学特性,因对不同分化程度的肝癌有不同的造影表现而可对典型与非典型肝癌进行鉴别诊断。
Objective To explore sonographic features of contrast-enhanced ultrasound between typical liver cancer and atypical liver cancer. Methods Specimens from 148 patients with focal liver lesions were included in this study. 47 patients who were not up to the principles of European ultrasound contrast agent were as the atypical liver cancer group and substandard total of 80 patients were as the typical liver cancer group. All patients were definitely diagnosed by pathological examination. Compared the consistence of the results between contrast-enhanced ultrasound and pathological examination, and the differences of the sonographic features between the 2 groups. Results The result of the consistency test showed their better consistency （ Kappa = 0. 784）. The diagnosis accurate rate of typical liver cancer by contrast-enhanced ultrasound was 98.75% and atypical liver cancer 95.74%. There were no significant difference in the diagnosis accurate rate of the 2 groups （ X2 = 0. 847, P 〉 0.05 ）. There were no significant difference in the enhance time and last time between the typical liver cancer and atypical liver cancer（ P 〉 0.05 ）. The difference of the regression time between the typical liver cancer and atypical liver cancer was statistically significant （ P 〈 0.05 ）. There were no significant difference for the representation of enhance period of well-differentiated Type Ⅰ （ X2 = 0. 554） , the poorly differentiated Type Ⅱ- Ⅲ（ x2 = 0. 478 ） of the typical liver cancer and atypical liver cancer （ P 〉 0.05 ）. The difference of the representation of portal venous phase of well-differentiated Type I （ X2 = 6. 987 ） , the poorly differentiated Type Ⅱ- Ⅲ （ x2 = 6.014 ） of the typical liver cancer and atypical liver cancer was statistically significant （ P 〈 0.05 ）. The difference of the reinforcing for Type Ⅰ （ X2 = 6. 845 ） , Type Ⅱ- Ⅲ（ x2 = 5.995 ） of the typical liver cancer and atypical liver cancer was statisti- cally significant （ P 〈 0.05 ）. Conclusion The contrast-enhanced ultrasound can simulate the hemodynamics of the liver cancer. Differentiation degree and the biological character of tumor has different representation, to different alcoholic typical liver cancer from atypical liver cancer by the different sonographic features.
出处
《实用癌症杂志》
2017年第4期571-574,共4页
The Practical Journal of Cancer
关键词
超声造影
快进慢出
非典型肝癌
典型肝癌
Contrast enhanced ultrasound
Fast in and slow-out
Atypical liver cancer
Typical liver cancer
