超声造影对肝硬化背景下小肝癌早期诊断价值评估.docVIP

超声造影对肝硬化背景下小肝癌早期诊断价值评估 　　[摘要]目的 ?u估超声造影对肝硬化背景下小肝癌的早期诊断价值。方法 选取我院2016年9月～2017年9月收治的肝硬化背景下小肝癌患者25例（60个病灶），均经穿刺活检后病理确诊。对所有患者均行超声造影检查，将灵敏度、各个病灶的造影增强消退时间、造影增强模式进行记录，并将造影前后，患者占位性病变的良恶性评分情况进行分析。结果 超声造影共检出23例肝硬化背景下小肝癌患者，灵敏度为92.00%（23/25）。中-低分化癌组开始增强时间为（14.22±5.35）s，明显短于透明细胞癌组，差异有统计学意义（P0.05）；中-低分化癌组开始消退时间为（60.15±46.57）s，比高分化癌组明显更短，差异有统计学意义（P0.05）；小肝癌病灶增强模式比较发现，实质期小肝癌内超声回声强度低于正常肝实质时，则为快出，检出发现，共存在39个病灶，占比65.00%。其中38个为中-低分化癌病灶，1个为透明细胞癌病灶；60个病灶中，共34例诊断为恶性，占56.67%。造影前后超声评分比较，造影后评分为5分的病灶为51个，小肝癌诊断准确率为85.00%。结论 在肝硬化背景下小肝癌的早期诊断，超声造影有较高的临床价值。可提高超声诊断的准确性，灵敏性较高。可作为临床早期诊断小肝癌的辅助影像学方法，值得在临床中进一步推广应用。 　　[关键词]小肝癌；肝硬化；超声造影；早期诊断；价值 　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721（2018）2（c）-0078-03 　　[Abstract]Objective To evaluate the early diagnostic value of contrast-enhanced ultrasound on small hepatocellular carcinoma at the background of liver cirrhosis.Methods In this study，the observation subjects were all selected from the patients with small liver cancer at the background of liver cirrhosis admitted in our hospital from September 2016 to September 2017.A total of 25 cases （60 lesions） were selected and confirmed by pathological examination after needle biopsy.All subjects were given contrast echocardiography.The sensitivity，the duration of contrast-enhanced ultrasound remission of each lesion，and contrast enhancement mode were recorded.The scores of benign and malignant occupying lesions were analyzed before and after contrast ultrasonography.Results 23 patients with small hepatocellular carcinoma at the background of liver cirrhosis were detected by contrast-enhanced ultrasonography.The sensitivity was 92.00%（23/25）.The initial enhancement time in the moderate-poorly differentiated cancer group was （14.22±5.35） s，which was significantly shorter than that in the clear cell carcinoma group.The difference between the two groups was statistically significant （P 　　[Key words]Small liver cancer；Liver cirrhosis；Contrast-enhanced ultrasound；Early diagnosis；Value 　　作为临床中常见的一种恶性肿瘤，肝癌具有发病率高、