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目的应用实时超声造影技术观察肝细胞癌及肝内胆管细胞癌的血流灌注特征,探讨其对两者的鉴别诊断价值。方法肝细胞癌组患者29例34个结节,肝内胆管细胞癌组患者8例12个结节。观察注射造影剂SonoVue后两组肿瘤结节的血流灌注特征,并用I mageLab软件绘制时间强度曲线,分析造影增强期及消退期各参数。结果两组造影特征均为“快进快出”,两组间的时间强度曲线形态相似,始增时间、峰值时间、增强时间及下降斜率等参数差异均无统计学意义(P>0.05)。但到达峰值时间时,两组肿瘤结节血流灌注模式的差异具有统计学意义(P<0.05),肝细胞癌组主要表现为整体型(22/34)或部分型(10/34),肝内胆管细胞癌组主要为周边型(10/12)。结论实时超声造影技术对肝细胞癌及肝内胆管细胞癌有鉴别诊断价值。
Objective To observe the perfusion characteristics of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (HCC) with real-time contrast-enhanced ultrasound and to explore its differential diagnostic value. Methods Twenty-nine nodules in 29 patients with hepatocellular carcinoma and 12 nodules in 8 patients with intrahepatic cholangiocarcinoma were included. The blood perfusion characteristics of tumor nodules in two groups after injection of contrast agent SonoVue were observed. The time intensity curve was drawn with I mageLab software to analyze the parameters of contrast enhanced phase and extinction phase. Results The angiographic features of both groups were fast forward and fast. The time intensity curves of the two groups were similar in shape. There were no significant differences in the parameters of onset time, peak time, enhancement time and descending slope between the two groups (P> 0.05). However, at the peak time, there was a significant difference in the pattern of perfusion of tumor nodules between the two groups (P <0.05). The main manifestations of HCC were overall (22/34) or partial (10/34) Intrahepatic cholangiocarcinoma group mainly peripheral (10/12). Conclusion Real-time contrast-enhanced ultrasound has the value of differential diagnosis in hepatocellular carcinoma and intrahepatic cholangiocarcinoma.