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本文报道应用彩色多普勒血流图像（ＣＤＦＩ）及术中Ｂ超（ＩＯＵＳ）诊断小肝癌９例。显示小肝癌的肿瘤内外动脉血流图像占８８．８％（８／９），动脉阻力指数（ＡＲＩ）均＞６０％（范围６８％～８９％），网篮征５５．５％（５／９）。其它小肝占位性病变（血管瘤、炎性假瘤、脂肪瘤、肝囊肿、肝结核），ＣＤＦＩ、ＡＲＩ＞６０％及网篮征检出率明显低于小肝癌（Ｐ＜０．０１）。具有鉴别诊断意义。本组ＣＤＦＩ对小肝癌诊断率为８８．８％（８／９），１例漏诊，由ＩＯＵＳ诊断，肿瘤为位于右叶后方上段，＜２．０ｃｍ的病例。ＣＤＦＩ具有无创性、操作简便、血流图像检出率高等特点，从而进一步提高超声诊断的特异性。ＩＯＵＳ可进一步辅助ＣＤＰＩ诊断的不足，特别是对ＡＦＰ阴性，瘤体位于盲区的小肝癌。
This paper reports 9 cases of small hepatocellular carcinoma diagnosed by color Doppler flow imaging (CDFI) and intraoperative ultrasound (IOUS). The image of the internal and external arteries showing small hepatocellular carcinoma accounted for 88.8% (8/9), the arterial resistance index (ARI) was >60% (range 68% to 89%), and the basket sign was 55.5% (5/ 9). Other small hepatic space-occupying lesions (hemangioma, inflammatory pseudotumor, lipoma, hepatic cyst, hepatic tuberculosis), CDFI, ARI>60% and net basket detection rate were significantly lower than those of small hepatocellular carcinoma (P<0.01). ). With a differential diagnosis. The diagnosis rate of CDFI in this group was 88.8% (8/9) for small hepatocellular carcinoma, 1 case was missed diagnosis, diagnosed by IOUS, and the tumor was located in the upper part of the right lobe, <2.0 cm. CDFI has the characteristics of non-invasive, easy operation, and high blood flow image detection rate, thereby further improving the specificity of ultrasound diagnosis. IOUS can further assist in the deficiency of CDPI diagnosis, especially for small HCC with negative AFP and tumor located in the blind area.