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目的探讨超声造影(CEUS)和彩色多普勒超声对肝硬化合并小肝癌的诊断价值。方法179例肝局灶性病变行CEUS,其中经手术或穿刺病理确诊小肝癌(≤3cm)39例44枚病灶,分析44枚病灶的彩色多普勒超声表现及造影增强模式。结果44枚小肝癌病灶中,有42枚(95.5%)CEUS动脉期高增强,2枚(4.5%)等增强。39枚(88.6%)在门脉期及延迟期增强消退为低增强。小肝癌CEUS的表现以动脉期呈高增强、门脉期呈等或低增强、实质期呈低增强为标准,确诊率为86.4%;彩色多普勒超声确诊率为29.5%,前者高于后者(P<0.01)。结论CEUS能提高肝硬化背景下小肝癌的诊断率。
Objective To investigate the diagnostic value of contrast echocardiography (CEUS) and color Doppler ultrasonography in cirrhosis with small hepatocellular carcinoma. Methods One hundred and ninety - nine patients with focal hepatic fibrosis underwent CEUS. Forty - four lesions of 39 patients with small hepatocellular carcinoma (≤3 cm) were confirmed by operation or puncture pathology. The color Doppler echocardiography and contrast enhancement patterns of 44 lesions were analyzed. Results Of the 44 small hepatocellular carcinoma lesions, 42 (95.5%) had CEUS arterial phase hyperactivity and 2 (4.5%) increased. Thirty-nine patients (88.6%) showed enhanced enhancement in the portal phase and in the delayed phase. The appearance of CEUS of small hepatocellular carcinoma showed high enhancement in arterial phase, equal or lower enhancement in portal phase, low enhancement in substantive stage as the standard, the diagnosis rate was 86.4%; the diagnostic rate of color Doppler ultrasound was 29.5% (P <0.01). Conclusions CEUS can improve the diagnosis of small liver cancer in cirrhosis.