摘要
目的分析超声造影在微小肝细胞癌中的诊断效能与其影像特征。方法选取98例肝内微小占位(直径≤2 cm)患者,对所有患者均施以常规超声与超声造影检查,以病理检查为“金标准”,统计分析常规超声、超声造影在微小肝细胞癌中的诊断效果。另统计分析两种检查的影像特征。结果98例肝内微小占位患者中,经病理检查证实为微小肝细胞癌的共有53例;超声造影共检出51例微小肝细胞癌,常规超声共检出44例微小肝细胞癌。超声造影检查微小肝细胞癌的灵敏度为92.45%(49/53)、准确度为93.88%(92/98)、阴性预测值为91.49%(43/47),高于常规超声的75.47%(40/53)、82.65%(81/98)、75.93%(41/54),有统计学差异(P<0.05);而两者的特异度、阳性预测值相比,无统计学差异(P>0.05)。kappa检验显示:超声检查微小肝细胞癌与“金标准”检查结果具有极好的一致性(kappa值=0.877,P=0.000);而常规超声与“金标准”检查结果存在中等的一致性(kappa值=0.656,P=0.000)。53例微小肝细胞癌患者中,常规超声可见21例低回声、12例等回声、13例高回声、7例混合回声。超声造影可见40例“快进快出型”,即动脉相病灶高增强,门脉相或延迟相消退为低回声;13例可见“快进同出型”,即动脉期快速增强,门脉期及延迟期无明显减退。结论超声造影在微小肝细胞癌的诊断中效果显著,具有与病理检查极好的一致性,且具有典型的影像特征,可为医师提供可靠的参考,临床应用价值较高。
Objective To analyze the diagnostic efficacy and imaging features of contrast-enhanced ultrasound in small hepatocellular carcinoma.Methods 98 patients with small intrahepatic masses(diameter≤2 cm)were selected,and all patients were subjected to routine ultrasound and contrast-enhanced ultrasound examination.Pathological examination was used as the"gold standard",and the diagnostic effects of routine ultrasound and contrast-enhanced ultrasound in small hepatocellular carcinoma were statistically analyzed;Statistical analysis of the imaging features of the 2 examination measures.Results Among the 98 patients with small intrahepatic masses,a total of 53 cases were confirmed by pathological examination as small hepatocellular carcinoma;A total of 51 cases of minimal hepatocellular carcinoma were detected by contrast-enhanced ultrasound,while 44 cases were detected by conventional ultrasound.The sensitivity,accuracy,and negative predictive value of contrast-enhanced ultrasound for detecting small hepatocellular carcinoma were 92.45%(49/53),93.88%(92/98),and 91.49%(43/47),which were higher than 75.47%(40/53),82.65%(81/98),and 75.93%(41/54)of conventional ultrasound,with statistical differences(P<0.05);However,there was no statistically significant difference in the specificity and positive predictive value between the 2(P>0.05).The kappa test showed excellent consistency between ultrasound examination of small hepatocellular carcinoma and the"gold standard"examination results(kappa value=0.877,P=0.000);There was moderate consistency between the results of conventional ultrasound and the"gold standard"examination(kappa value=0.656,P=0.000).Among 53 patients with minimal hepatocellular carcinoma,conventional ultrasound showed 21 cases of hypoechogenicity,12 cases of isoechogenicity,13 cases of hyperechogenicity,and 7 cases of mixed echogenicity.Ultrasound contrast-enhanced imaging showed 40 cases of"fast in and fast out type",which showed high enhancement of arterial phase lesions and regression to low echo in portal or delayed phase;13 cases showed a"fast in and out type",which means rapid enhancement in the arterial phase,with no significant decrease in the portal and delayed phases.Conclusion Contrast-enhanced ultrasound has a significant effect in the diagnosis of small hepatocellular carcinoma,with excellent consistency with pathological examination and typical imaging features.It can provide reliable reference for physicians and has high clinical application value.
作者
李彦
郭睿
LI Yan;GUO Rui(Shangqiu First People's Hospital,Shangqiu,476000)
出处
《实用癌症杂志》
2023年第9期1507-1509,1514,共4页
The Practical Journal of Cancer
关键词
微小肝细胞癌
超声造影
诊断效能
Minimal hepatocellular carcinoma
Contrast-enhanced ultrasound
Diagnostic effectiveness
