| 张哲元,王修明,谭庆亭,谢霞,张雷,栾好梅,王博娟,刘群,张华斌,白志勇.肝细胞癌与肝内胆管细胞癌/肝转移癌[J].中国医学影像技术,2025,41(6):933~937 |
| 肝细胞癌与肝内胆管细胞癌/肝转移癌 |
| Intensity ratio of lesion to non-tumor liver parenchyma on contrast-enhanced ultrasound Kupffer phase for differentiating hepatocellular carcinoma and intrahepatic cholangiocarcinoma/metastatic liver carcinoma |
| 投稿时间：2024-11-10 修订日期：2025-03-31 |
| DOI：10.13929/j.issn.1003-3289.2025.06.018 |
| 中文关键词: 肝肿瘤 超声检查 库普弗细胞 |
| 英文关键词:liver neoplasms ultrasonography Kupffer cells |
| 基金项目:北京市属医院科研培育计划项目(PX2025033)。 |
| 作者 | 单位 | E-mail | | 张哲元 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 王修明 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 谭庆亭 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 谢霞 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 张雷 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 栾好梅 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 王博娟 | 山西医科大学第二医院超声科, 山西 太原 030001 | | | 刘群 | 滨州医学院附属医院超声医学科, 山东 滨州 256603 | | | 张华斌 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | | | 白志勇 | 清华大学北京清华长庚医院超声科 清华大学临床医学院, 北京 102218 | zhiyongbai@sina.com |
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| 中文摘要: |
| 目的 探讨超声造影(CEUS)Kupffer相病灶与非瘤肝实质强度比值(IR)鉴别肝细胞癌(HCC)与肝内胆管细胞癌(IHC)/肝转移癌的价值。方法 回顾性纳入54例HCC(HCC组)、30例IHC及51例肝转移癌(非HCC组),对比组间基于CEUS时间-强度曲线所获定量参数,包括血管相病灶峰值强度(PI)、达峰时间(TTP)、灌注曲线下面积(WiAUC)、廓清曲线下面积(WoAUC)、灌注廓清曲线下面积(WiWoAUC)及Kupffer相病灶与非瘤肝实质IR;采用二元logistic回归分析法基于组间差异有统计学意义的参数建立联合诊断模型。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)评估各单一CEUS参数及联合模型鉴别HCC与IHC/肝转移癌的效能。结果 HCC组PI、WoAUC及WiWoAUC均明显高于(P均＜0.001)、而IR明显低于非HCC组(P＜0.001)。PI、WoAUC、WiWoAUC及IR鉴别HCC与IHC/肝转移癌的AUC分别为0.673、0.741、0.738及0.736,均低于联合模型(0.862,P均＜0.05)。结论 CEUS Kupffer相病灶与非瘤肝实质IR可用于鉴别HCC与IHC/肝转移癌;结合血管相定量参数可提高鉴别效能。 |
| 英文摘要: |
| Objective To explore the value of intensity ratio (IR) of lesion to non-tumor liver parenchyma on contrast-enhanced ultrasound (CEUS) Kupffer phase for differentiating hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHC)/metastatic liver carcinoma. Methods Totally 54 patients with HCC (HCC group), 30 with IHC and 51 with liver metastatic carcinoma (non-HCC group) diagnosed by pathology were retrospectively enrolled. Quantitative parameters derived from CEUS time-intensity curves, including peak intensity (PI), time to peak (TTP), wash-in area under the curve (WiAUC), wash-out area under the curve (WoAUC), wash-in and wash-out area under the curve (WiWoAUC) of lesion in vascular phase and IR of lesion to non-tumor liver parenchyma in Kupffer phase were compared between groups, and a combined diagnostic model was established based on parameters being significantly different between groups using binary logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted, and the area under the curves (AUC) were calculated to evaluate the efficacy of each CEUS parameter alone and the combined model for differentiating HCC and IHC/liver metastatic carcinoma. Results In HCC group, PI, WoAUC and WiWoAUC were all higher (all P＜0.001), while IR was significantly lower than those in non-HCC group (P＜0.001). The AUC of PI, WoAUC, WiWoAUC and IR for differentiating HCC and IHC/metastatic liver carcinoma was 0.673, 0.741, 0.738 and 0.736, respectively, all lower than that of combined model (0.862, all P＜0.05). Conclusion IR of lesion to non-tumor liver parenchyma on CEUS Kupffer phase could be used to differentiate HCC and IHC/metastatic liver carcinoma. Combining with quantitative parameters on CEUS vascular phase could improve differentiating efficiency. |
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