【摘要】 目的探讨超声造影在肝癌高危患者筛选诊断中的应用价值。方法对肝癌高危患者行常规超声、CT及MR影像学检查,对影像学检查发现肝内占位性病变但不能定性,或血清甲胎蛋白(AFP)检测值明显增高而影像学检查未发现占位性病变的57例患者随诊复查或超声造影检查,确定有无异常灌注的占位病灶,分析各时相异常灌注的回声特点与增强模式,并与穿刺活检或手术病理诊断结果对照分析。结果 57例随访检查中通过穿刺活检、手术病理或超声造影检查诊断为微小肝细胞肝癌25例(病灶直径均≤2.0cm),其中常规超声诊断为微小肝细胞肝癌10例,诊断符合率为40.0%(10/25);超声造影诊断为微小肝细胞肝癌21例,诊断符合率为84.0%(21/25)。常规超声与超声造影定性诊断符合率比较差异有统计学意义(P<0.05)。结论超声造影有助于提高从肝癌高危患者中筛选诊断微小肝细胞肝癌的诊断符合率,对肝癌高危患者动态随诊、筛选诊断微小肝癌有重要意义。更多还原

【Abstract】 Objective To evaluate the diagnostic performance of ultrasound contrast in diagnosing and monitoring hepatocellular carcinoma (HCC) in high-risk subjects. Methods Baseline ultrasound and/or other imaging examination were performed on 57 cases with small focal liver lesions or the serum levels of α-fetoprotein was significant higher but without any nodule on atlas. All cases chosen from HBV carriers,patients had chronic hepatitis B,C,and cirrhosis. Ultrasound contrast examination was carried out with Sonovue and CnTI techniques. Abnormal filling nodules were observed,the characeristics of phases and enhancement patterns were analysed. The diagnostic outcomes were calculated by using histologic results as the reference standard. Results Of 57 cases,all diameters of small focal liver lesions were ≤2.0 cm,25 were micro-hepatocellular carcinoma. According to the diagnostic criteria of baseline ultrasound,the rate of correct diagnosis of HCC was 40.0% (10/25). Therefore,the diagnostic accuracy of ultrasound contrast was 84.0% (21/25 ). There was significant difference between baseline ultrasound and ultrasound contrast in the diagnostic confidence of small hepatic nodules. Conclusions Ultrasound contrast significantly improves the diagnostic performance in characterization of small HCCs,which provides a new way for monitoring high-risk subjects and diagnosing micro-hepatocellular carcinoma.更多还原