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中国癌症防治杂志 ›› 2014, Vol. 6 ›› Issue (2): 159-163.doi: 10.3969/j.issn.1674-5671.2014.02.12

• 临床研究 • 上一篇    下一篇

超声造影与增强CT检查诊断小于2 cm肝细胞癌的对比研究

  

  1. 广西医科大学第一附属医院1肝胆外科;超声诊断科
  • 出版日期:2014-06-25 发布日期:2014-07-08
  • 通讯作者: 杨 红 E-mail:yanghonggx@163.com
  • 基金资助:

    国家自然科学基金资助项目(81260222);广西卫生厅科研基金资助项目(重2011089,Z2011324);中国肝炎防治基金会天晴肝病研究基金资助课题(TQGB2011021)

Comparison of CEUS and contrast-enhanced CT for diagnosis of <2 cm hepatocellular carcinoma

  • Online:2014-06-25 Published:2014-07-08

摘要: 目的 探讨超声造影(contrast-enhanced ultrasonography,CEUS)在乙肝相关肝细胞癌(hepatocellular carcinoma, HCC)高危人群中诊断< 2 cm HCC的应用价值。方法 2011年1月至2012年12月,我院对乙肝相关HCC高危人群进行B超筛查,其中对< 2 cm肝占位的77例患者86个病灶行CEUS和增强CT(contrast-enhanced computed tomography,CECT)检查,以病理检查结果为金标准,对比分析CEUS与CECT检查诊断< 2 cm HCC的敏感性、特异性和准确性。结果 CEUS和CECT在诊断< 2 cm HCC的敏感性、特异性、准确性分别为81.0%、88.6%、84.9%和76.2%、90.9%、83.7%,分别比较两者的差异均无统计学意义(P均>0.05)。CEUS对CECT检查不能确定的2个病灶显示出典型的HCC增强模式,最终该2个病灶经病理诊断为HCC。结论 对于乙肝相关HCC高危人群,CEUS在诊断< 2 cm HCC的效能上与CECT检查一致;CEUS对乙肝相关HCC高危人群的随访及部分可疑病灶的诊断较CECT检查具有一定的优越性。

关键词: 肝肿瘤, 肝细胞癌, 乙型肝炎病毒, 超声造影, 诊断

Abstract: Objective To investigate the diagnostic value of CEUS for small (<2 cm) hepatic nodules detected by surveillance ultrasound in patients infected with hepatitis B virus(HBV). Methods A total of 77 liver cirrhosis patients with 86 small hepatic nodules(<2 cm) were examined by both CEUS and contrast-enhanced CT.Histopathology based on biopsy or surgery served as the diagnostic gold standard for comparing the sensitivity,specificity,and accuracy of CEUS and CT. Results Sensitivity,specificity,and accuracy were 81.0%,88.6%,and 84.9% for CEUS,similar to the corresponding values of 76.2%,90.9%,and 83.7% for contrast-enhanced CT.Two nodules were correctly diagnosed by CEUS but were misdiagnosed by CT. Conclusion CEUS shows similar ability as contrast-enhanced CT to characterize small nodules(<2 cm) detected by surveillance in patients infected with hepatitis B virus. However,CEUS may be particularly helpful for diagnosing suspicious lesions and for performing follow up.

Key words:  Liver neoplasm, Hepatocellular carcinoma, HBV, Contrast-enhanced ultrasonography, Diagnosis