超声造影参量成像在肝细胞肝癌与肝内胆管细胞癌显示与鉴别中的应用价值
The value of contrast-enhanced ultrasound parametric imaging in the differential diagnosis of hepatocellular carcinoma and intrahepatic cholangiocarcinoma
尹璐璐 1薛海燕 1孔文韬1
作者信息
- 1. 南京大学医学院附属鼓楼医院超声科 江苏 南京 210000
- 折叠
摘要
目的 探讨超声造影参量成像在显示与鉴别肝细胞肝癌(hepatocellular carcinoma,HCC)和肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)中的应用价值.方法 选取经穿刺或手术病理证实的 157 例原发性肝癌患者的临床与影像资料,分为HCC组 76 例,ICC组 81 例.将不同模态显示的图像清晰度分为 0～3 分,分析灰阶超声、超声造影与参量成像图在两种疾病中的显示清晰度.将超声造影后处理的参量成像模式分为 0～3 类,比较两者参量成像图模式差异及诊断效能.结果 1)肿瘤最大直径≤3 cm中,参量成像 1 类作为HCC诊断标准的灵敏度为 80.7%、阳性预测值为80.7%,均较肿瘤最大直径>3 cm时提高;3 类作为ICC诊断标准的灵敏度为 22.2%、阳性预测值为 100%,均较肿瘤最大直径>3 cm时提高;2)HCC组参量成像模式主要以 1 类红橙黄为主的类型,占 68.4%,且比例明显高于ICC组,差异有统计学意义(P<0.001);3)HCC组与ICC组患者在灰阶超声、超声造影动脉期与参量成像中病灶清晰度评分的构成比差异有统计学意义(P<0.01).结论 超声造影动脉期与参量成像对HCC的显示清晰度明显高于ICC,HCC与ICC在参量成像图上表现出不同类型,有助于鉴别诊断.
Abstract
Objective To investigate the value of contrast-enhanced ultrasound(CEUS)parametric imaging in the differen-tial diagnosis of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).Methods 157 patients with pri-mary liver cancer confirmed by surgery or puncture pathology were retrospectively analyzed,including 76 cases of HCC and 81 cases of ICC.The resolution of images displayed in different modes was divided into 0 to 3 points,and the resolution of gray scale ultrasound,contrast-enhanced ultrasound and parametric imaging in the two diseases was analyzed.The parametric imaging modes of CEUS post-processing were divided into 0-3 categories,and the differences of the two parametric imaging modes and their diagnostic efficiency were compared.Results 1)For the tumor with maximum diameter less than 3cm,both the sensitivity and positive predictive value were 80.7%when parametric imaging classification 1 as a diagnostic criterion for HCC.Whereas,the sensitivity and positive predictive value were 22.2%and 100%for ICC when classification 3 as a diagnostic criterion,both of which were higher than those of the tumor with maximum tumor diameter＞3cm;2)Parametric imaging classification 1 was the primary type of HCC group,accounting for 68.4%.The proportion was significantly higher than that in ICC group,with statistical significance(P＜0.001);and 3)Multimodal US showed there was a statistically significant difference between HCC and ICC group in the constituent ratio of clarity score(P<0.01).Conclusion The arterial phase of CEUS and parametric imaging shows better clarity for HCC than for ICC.HCC and ICC have different types on parametric imaging,which is helpful for differential di-agnosis.
关键词
肝细胞肝癌/肝内胆管细胞癌/超声造影/参量成像Key words
Hepatocellular carcinoma/Intrahepatic cholangiocarcinoma/Contrast enhanced ultrasound/Parametric imaging引用本文复制引用
出版年
2024
NETL
NSTL
万方数据