本文選題：膽管癌 + 癌��； 參考：《中國(guó)醫(yī)學(xué)影像技術(shù)》2017年05期

【摘要】：目的比較肝內(nèi)膽管細(xì)胞癌(ICC)和不同分化程度肝細(xì)胞癌(HCC)CEUS表現(xiàn)對(duì)ICC和不同分化程度HCC的鑒別診斷價(jià)值。方法回顧性分析經(jīng)病理證實(shí)的34例ICC(ICC組)和136例不同分化程度的HCC患者高、中、低分化(HCC組)的常規(guī)超聲及CEUS表現(xiàn),并評(píng)價(jià)CEUS始退時(shí)間對(duì)ICC的診斷效能。結(jié)果 ICC組在門靜脈早期開始消退的比例(24/34,70.59%)均高于各HCC組,在門靜脈中期開始消退的比例(0/34)和在門靜脈晚期/延遲期開始消退的比例(4/34,11.76%)均低于中、高分化HCC組,差異均有統(tǒng)計(jì)學(xué)意義(P均0.008)。低分化HCC組在門靜脈中期開始消退的比例(16/41,39.02%)高于高分化HCC組(P0.008)。CEUS診斷ICC的敏感度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值、準(zhǔn)確率、陽(yáng)性似然比及陰性似然比分別為82.35%(28/34)、91.18%(124/136)、70.00%(28/40)、95.38%(124/130)、89.41%(152/170)、9.4、0.2。ICC及低、中、高分化HCC組病灶CEUS始增時(shí)間分別為(13.03±3.49)s、(13.80±3.04)s、(14.89±4.12)s、(16.00±3.38)s,差異有統(tǒng)計(jì)學(xué)意義(F=4.369,P0.05),ICC組始增時(shí)間早于高分化HCC組(P0.05)。結(jié)論不同分化程度HCC和ICC的CEUS表現(xiàn)存在差異,CEUS對(duì)其鑒別診斷有一定的參考價(jià)值。
[Abstract]:Objective to compare the differential diagnostic value of ICC and HCC with different differentiation degree of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods the conventional ultrasound and CEUS findings of 34 cases of pathologically proved HCC and 136 cases of HCC with different differentiation were analyzed retrospectively, and the diagnostic efficacy of the onset time of CEUS for ICC was evaluated. Results in ICC group, the rate of extinction in early portal vein (24 / 34) was higher than that in other HCC groups (0 / 34) and in late portal vein / delayed phase (4 / 34 / 11.76g), respectively, which was significantly lower than that in well-differentiated HCC group. The difference was statistically significant (P = 0.008). The proportion of the low-differentiated HCC group that began to fade in the middle of the portal vein was 16 / 41 / 39.02) higher than that in the well-differentiated HCC group (P0.008N. CEUS). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio and negative likelihood ratio were 82.35% 281.18124P 1360.The ratio of positive likelihood to negative likelihood was 82.35%, respectively. In the well-differentiated HCC group, the onset time of CEUS was 13.03 鹵3.49s (13.80 鹵3.04s) and 14.89 鹵4.12m (16.00 鹵3.38g), respectively. The difference was statistically significant (P < 0.01). The time of initiation of CEUS in the well-differentiated HCC group was earlier than that in the well-differentiated HCC group (P 0.05). Conclusion there are differences in CEUS manifestations between HCC and ICC with different degrees of differentiation. CEUs has some reference value in differential diagnosis.
【作者單位】： 中南大學(xué)湘雅醫(yī)院超聲影像科;
【分類號(hào)】：R445.1;R735.8

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