| 杨伯文,廖锦堂,王译斌,田婷.胆管细胞癌与不同分化程度肝细胞癌CEUS特征的对比研究[J].中国医学影像技术,2017,33(5):713~717 |
| 胆管细胞癌与不同分化程度肝细胞癌CEUS特征的对比研究 |
| Comparasion of contrast-enhanced ultrasound in diagnosis of cholangiocarcinoma and different differentiated hepatocellular carcinoma |
| 投稿时间：2016-10-01 修订日期：2017-02-21 |
| DOI：10.13929/j.1003-3289.201610003 |
| 中文关键词: 胆管癌 癌,肝细胞 超声检查 造影剂 细胞分化 |
| 英文关键词:Cholangiocarcinoma Carcinoma, hepatocellular Ultrasonography Contrast media Cell differentiation |
| 基金项目: |
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| 摘要点击次数: 2589 |
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| 中文摘要: |
| 目的 比较肝内胆管细胞癌（ICC）和不同分化程度肝细胞癌（HCC）CEUS表现对ICC和不同分化程度HCC的鉴别诊断价值。方法 回顾性分析经病理证实的34例ICC（ICC组）和136例不同分化程度的HCC患者高、中、低分化（HCC组）的常规超声及CEUS表现，并评价CEUS始退时间对ICC的诊断效能。结果 ICC组在门静脉早期开始消退的比例（24/34，70.59%）均高于各HCC组，在门静脉中期开始消退的比例（0/34）和在门静脉晚期/延迟期开始消退的比例（4/34，11.76%）均低于中、高分化HCC组，差异均有统计学意义（P均<0.008）。低分化HCC组在门静脉中期开始消退的比例（16/41，39.02%）高于高分化HCC组（P<0.008）。CEUS诊断ICC的敏感度、特异度、阳性预测值、阴性预测值、准确率、阳性似然比及阴性似然比分别为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组病灶CEUS始增时间分别为（13.03±3.49）s、（13.80±3.04）s、（14.89±4.12）s、（16.00±3.38）s，差异有统计学意义（F=4.369，P<0.05），ICC组始增时间早于高分化HCC组（P<0.05）。结论 不同分化程度HCC和ICC的CEUS表现存在差异，CEUS对其鉴别诊断有一定的参考价值。 |
| 英文摘要: |
| Objective To compare the characteristics of intrahepatic cholangiocarcinoma (ICC) and different differentiated hepatocellular carcinoma (HCC) by CEUS and evaluate the diagnostic value of CEUS. Methods The cases who underwent CEUS and were pathologically demonstrated as ICC (n=34) and HCC (n=136) were observed. The characteristics of ICC and different differentiated HCC in conventional ultrasound and CEUS were analyzed, and the diagnostic efficiency of washout time were calculated. Results ICC had higher percentage (24/34, 70.59%) of washout emerging in early portal phase than those of HCC. And ICC had lower percentage (0; 4/34, 11.76%) of washout emerging in middle and late portal phase than poorly and moderate differentiated HCC. Poorly differentiated HCCs had higher percentage (16/41, 39.02%) of washout emerging in middle portal phase than well differentiated HCC. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio and negative likelihood ratio of washout time in diagnosis of ICC were 82.35% (28/34), 91.18% (124/136), 70.00% (28/40), 95.38% (124/130), 89.41% (152/170), 9.4, 0.2, respectively. The rise time of ICC and well, moderate and poorly differentiated HCC were (13.03±3.49)s, (13.80±3.04)s, (14.89±4.12)s, (16.00±3.38)s, respectively, and the difference was significant (F=4.369, P<0.05). The rise time of ICC was significantly higher than that of well differentiated HCC (P<0.05). Conclusion The CEUS performances are different significantly among ICCs and different differentiated HCCs, which has value for the differential diagnosis. |
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