本文選題：超聲造影　切入點：肝硬化　出處：《中國超聲醫(yī)學雜志》2017年08期 　論文類型：期刊論文

【摘要】：目的探討超聲造影(CEUS)對肝硬化背景下早期HCC的診斷效能,通過分析早期HCC增強特征,提高CEUS對早期HCC與增生結(jié)節(jié)的鑒別診斷能力。方法接受CEUS檢查的肝硬化患者2 130例,176例滿足入選標準。以超聲引導穿刺活檢病理診斷作為金標準,通過ROC曲線回顧性分析CEUS對不同直徑分層下HCC的診斷效能,并對早期HCC與增生結(jié)節(jié)的CEUS增強模式進行對比分析。結(jié)果 176例患者176個結(jié)節(jié)中HCC 127個,良性結(jié)節(jié)49個。85.8%(109/127)HCC結(jié)節(jié)在CEUS上表現(xiàn)為動脈期高增強,1~2cm組和2~3cm組中的81.0%和90.0%的HCC結(jié)節(jié)動脈期表現(xiàn)為高增強。1~2cm組和2~3cm組中HCC表現(xiàn)為典型增強模式的結(jié)節(jié)分別為72.4%和88.4%(P=0.022)。58個1~2cm組HCC,16個結(jié)節(jié)不符合指南推薦典型HCC的CEUS增強模式。結(jié)論 CEUS對肝硬化背景下HCC早期診斷及與各類增生結(jié)節(jié)的鑒別診斷具有較高的診斷效能;與直徑2~3cm的HCC相比,直徑1~2cm的HCC表現(xiàn)為典型增強模式的比例降低,應(yīng)高度警惕;動脈期高增強表現(xiàn)對早期HCC診斷具有重要價值,但應(yīng)注意與動脈期高增強的增生不良結(jié)節(jié)進行鑒別。
[Abstract]:Objective to evaluate the diagnostic efficacy of contrast-enhanced ultrasonography (CEUs) for early HCC in cirrhotic patients and to analyze the enhanced features of early HCC. Methods to improve the ability of CEUS in differential diagnosis of early HCC and hyperplastic nodules. Methods 2130 patients with liver cirrhosis underwent CEUS examination and 176 patients met the inclusion criteria. Ultrasound guided biopsy was used as the golden standard. The diagnostic efficacy of CEUS for HCC with different diameters was analyzed retrospectively by ROC curve, and the CEUS enhancement model of early HCC and hyperplastic nodules was compared with that of hyperplastic nodules. Results HCC 127 of 176 nodules were found in 176 patients. On CEUS, 49 cases of benign nodules. 85.8% 10 9 / 127 HCC nodules showed high enhancement in arterial phase in 1cm group and 81.0% and 90.0% in 2cm and 2cm group respectively. The typical enhancement patterns of HCC in 2cm and 22cm groups were 72.4% and 88.40.58, respectively. In the 2cm group, 16 nodules were not in accordance with the typical CEUS enhancement model recommended by the guidelines. Conclusion CEUS has high diagnostic efficacy in the early diagnosis of HCC in cirrhotic background and differential diagnosis with various proliferative nodules. Compared with HCC with diameter of 2 ~ 3 cm, the proportion of HCC with diameter of 1 ~ 2 cm was lower than that of typical enhancement model, and should be highly alert, and the high contrast enhancement of arterial phase was of great value in the diagnosis of early HCC. However, attention should be paid to the differentiation of hyperplastic nodules with high enhancement in arterial phase.
【作者單位】： 天津市第三中心醫(yī)院超聲科 天津市肝膽疾病研究所 天津市人工細胞重點實驗室 衛(wèi)生部人工細胞工程技術(shù)研究中心;
【基金】：天津市衛(wèi)生局科技基金資助(No.2013KY03)
【分類號】：R445.1;R575.2;R735.7

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本文編號：1603791