【摘要】 目的 研究超声造影技术在肝细胞性肝癌及胆管癌鉴别诊断中的价值。方法 选择湛江中心人民医院在2023年8月至2025年6月收治的69例肝细胞性肝癌患者和16例胆管癌患者，对所有患者均进行超声造影检查。对比两组一般资料、时间强度曲线相关参数、患者在不同超声类型检查中的图像清晰度评分。结果 肝细胞性肝癌组患者肝硬化率、AFP(+)率高于胆管癌组，CA-199(+)率低于胆管癌组(P<0.05)。肝细胞性肝癌组患者AT、PI均低于胆管癌组，TTP、RS均高于胆管癌组(P<0.05)。在灰阶超声、超声造影动脉期检查中，肝细胞性肝癌组患者的整体清晰度评分均高于胆管癌组(P<0.05)。结论 肝细胞性肝癌与胆管癌在灰阶超声、超声造影动脉期的图像清晰度存在明显差异，且时间强度曲线上的类型各不相同。通过应用超声造影检查，可对上述两种疾病进行准确的鉴别诊断。更多还原

【Abstract】 Objective:To study the value of contrast-enhanced ultrasound in the differential diagnosis of hepatocellular carcinoma and cholangiocarcinoma. Methods:From August 2023 to June 2025, 69 patients with hepatocellular carcinoma and 16 patients with cholangiocarcinoma were selected from Zhanjiang Central People’s Hospital, and all patients were examined by contrast-enhanced ultrasound. The general data, related parameters of time intensity curve and image clarity scores of patients in different types of ultrasound examinations were compared between the two groups. Results:The rate of cirrhosis and AFP(+) in HCC group was higher than that in cholangiocarcinoma group, and the rate of CA-199(+) was lower than that in cholangiocarcinoma group(P<0.05). AT and PI in HCC group were lower than those in cholangiocarcinoma group, while TTP and RS were higher than those in cholangiocarcinoma group(P<0.05). In gray-scale ultrasound and contrast-enhanced ultrasound arterial phase examination, the overall clarity score of patients with hepatocellular carcinoma was higher than that of patients with cholangiocarcinoma(P<0.05). Conclusion:There are obvious differences in image clarity between hepatocellular carcinoma and cholangiocarcinoma in gray-scale ultrasound and contrast-enhanced ultrasound in arterial phase, and the types of time intensity curves are different. Through the application of contrast-enhanced ultrasound examination, the above two diseases can be accurately differentiated and diagnosed.更多还原