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肝细胞肝癌超声造影增强模式对分化程度的诊断价值

夏宇 姜玉新 戴晴 吕珂 高嫔

夏宇, 姜玉新, 戴晴, 吕珂, 高嫔. 肝细胞肝癌超声造影增强模式对分化程度的诊断价值[J]. 协和医学杂志, 2014, 5(1): 46-49. doi: 10.3969/j.issn.1674-9081.2014.01.011
引用本文: 夏宇, 姜玉新, 戴晴, 吕珂, 高嫔. 肝细胞肝癌超声造影增强模式对分化程度的诊断价值[J]. 协和医学杂志, 2014, 5(1): 46-49. doi: 10.3969/j.issn.1674-9081.2014.01.011
Yu XIA, Yu-xin JIANG, Qing DAI, Ke LÜ, Pin GAO. Contrast-enhanced Ultrasound of Hepatocellular Carcinoma: Enhancement Pattern Features for Evaluation of Tumor Differentiation[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(1): 46-49. doi: 10.3969/j.issn.1674-9081.2014.01.011
Citation: Yu XIA, Yu-xin JIANG, Qing DAI, Ke LÜ, Pin GAO. Contrast-enhanced Ultrasound of Hepatocellular Carcinoma: Enhancement Pattern Features for Evaluation of Tumor Differentiation[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(1): 46-49. doi: 10.3969/j.issn.1674-9081.2014.01.011

肝细胞肝癌超声造影增强模式对分化程度的诊断价值

doi: 10.3969/j.issn.1674-9081.2014.01.011
基金项目: 

教育部留学回国人员科研启动基金 M426300

详细信息
    通讯作者:

    姜玉新 电话:010-69155491, E-mail:jiangyuxinxh@163.com

  • 中图分类号: R445.1

Contrast-enhanced Ultrasound of Hepatocellular Carcinoma: Enhancement Pattern Features for Evaluation of Tumor Differentiation

More Information
  • 摘要:   目的  探讨肝细胞肝癌的超声造影增强模式对于分化程度的诊断价值。  方法  回顾性分析81例手术病理证实的肝细胞肝癌患者的超声造影特点。将动脉期病灶内部开始增强、门脉期回声低于周边肝实质的增强模式定义为"快进快出"型; 将动脉期病灶内部开始增强、延迟期回声低于周边肝实质的增强模式定义为"快进慢出"型。根据病理结果将肝细胞肝癌分为高分化及中低分化两组。总结分析增强模式对于分化程度的诊断价值。  结果  81例肝细胞肝癌患者中, 高分化肝细胞肝癌38例, 中低分化者43例。17例(21.0%)高分化肝细胞肝癌超声造影表现为"快进慢出", 21例(25.9%)高分化肝细胞肝癌表现为"快进快出", 43例(53.1%)中低分化肝细胞肝癌表现为"快进快出"。"快进慢出"的增强模式在高分化肝细胞肝癌组较中低分化肝细胞肝癌组患者中更为常见(χ2=24.35, P < 0.01)。"快进慢出"的增强模式诊断高分化肝细胞肝癌的敏感性44.7%, 特异性100%, 阳性预测值100%, 阴性预测值67.2%, 准确率74.1%。  结论  超声造影"快进慢出"模式对提示及诊断高分化肝细胞肝癌可能有帮助。
  • 图  1  64岁男性高分化肝细胞肝癌患者超声造影表现为“快进慢出”增强模式(箭头所示为肿瘤)

    A.动脉期(24 s)不均匀快速增强;B.延迟期(4 min 19 s)廓清呈低回声

    图  2  56岁男性高分化肝细胞肝癌患者超声造影表现为“快进快出”增强模式(箭头所示为肿瘤)

    A.动脉期(17 s)不均匀快速增强;B.门脉期(52 s)廓清呈低回声

    图  3  45岁男性中低分化肝细胞肝癌患者超声造影表现为“快进快出”增强模式(箭头所示为肿瘤)

    A.动脉期(19 s)不均匀快速增强;B.门脉期(1 min 19 s)廓清呈低回声

  • [1] Salvatore V, Bolondi L. Clinical impact of ultrasound-related techniques on the diagnosis of focal liver lesions[J]. Liver Cancer, 2012, 1:238-246. doi:  10.1159/000343838
    [2] Friedrich-Rust M, Klopffleisch T, Nierhoff J, et al. Contrast-enhanced ultrasound for the differentiation of benign and malignant focal liver lesions:a meta-analysis[J]. Liver Int, 2013, 33:739-755. doi:  10.1111/liv.12115
    [3] Solbiati L, Tonolini M, Cova L, et al. The role of contrast-enhanced ultrasound in the detection of focal liver lesions[J]. Eur Radiol, 2001, 11(Suppl 3):E15-E26. http://www.ncbi.nlm.nih.gov/pubmed/3222368
    [4] Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference[J]. J Hepatol, 2001, 35:421-430. doi:  10.1016/S0168-8278(01)00130-1
    [5] Yang H, Liu GJ, Lu MD, et al. Evaluation of the vascular architecture of focal liver lesions using micro flow imaging[J]. J Ultrasound Med, 2013, 32:1157-1171. doi:  10.7863/ultra.32.7.1157
    [6] Breedis C, Young G. The blood supply of neoplasms in the liver[J]. Am J Pathol, 1954, 30:969-977.
    [7] Leen E, Angerson WJ, Yarmenitis S, et al. Multi-centre clinical study evaluating the efficacy of SonoVueTM(BR1), a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions[J]. Eur J Radiol, 2002, 41:200-206. doi:  10.1016/S0720-048X(01)00457-0
    [8] Quaia E, Degobbis F, Tona G, et al. Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue[J]. Radiol Med, 2004, 107:155-165. http://www.ncbi.nlm.nih.gov/pubmed/15031681/
    [9] Cosgrove D. A revolution in liver ultrasound[J]. Eur J Gastroenterol Hepatol, 2007, 19:1-2. doi:  10.1097/MEG.0b013e328011ff30
    [10] Hennedige T, Venkatesh SK. Imaging of hepatocellular carcinoma:diagnosis, staging and treatment monitoring[J]. Cancer Imaging, 2013, 8:530-547. http://pubmedcentralcanada.ca/pmcc/articles/PMC3666429/?lang=fr
    [11] Fan ZH, Chen MH, Dai Y, et al. Evaluation of primary malignancies of the liver using contrast-enhanced sonography:correlation with pathology[J]. Am J Roentgenol, 2006, 186:1512-1519. doi:  10.2214/AJR.05.0943
    [12] Kudo M, Tomita S, Kashida H, et al. Tumor hemodynamics in hepatic nodules associated with liver cirrhosis:relationship between cancer progression and tumor hemodynamic change[J]. Nippon Shokakibyo Gakkai Zasshi, 1991, 88:1554-1565. http://europepmc.org/abstract/MED/1658418
    [13] Xia Y, Jiang YX, Dai Q, et al. Contrast-enhanced ultrasound of hepatocellular carcinoma:correlation of washout time and angiogenesis[J]. Clin Hemorheol Microcirc, 2011, 48:265-273. doi:  10.3233/CH-2011-1420
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出版历程
  • 收稿日期:  2013-10-28
  • 刊出日期:  2014-01-30

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