超声造影在神经内分泌来源及非神经内分泌来源转移性肝癌中鉴别诊断的应用价值

发布时间：2018-04-23 12:49

本文选题：超声造影 + 鉴别诊断　；参考：《中国超声医学杂志》2017年11期

【摘要】：目的探讨超声造影(CEUS)在鉴别神经内分泌来源转移性肝癌(NETLM)及非神经内分泌来源转移性肝癌(NNETLM)中的应用价值。方法对经手术或穿刺病理证实的30例NETLM及50例NNETLM患者CEUS声像图进行回顾性分析,记录并评价病灶增强时间、增强方式及在动脉期(0~40s)、门脉期(40~120s)、延迟期(120s)各期的表现等。结果两组转移性肝癌病灶造影后均有不同程度的增强,其中NETLM的增强减退时间(44.73±22.70)s晚于NNETLM的减退时间(33.72±7.17)s(P0.05);两组转移性肝癌病灶动脉期的增强方式主要为环状增强和整体增强两种,其中NETLM表现为整体增强的比例(93.3%)明显高于NNETLM(56.0%)(P0.05);两组转移性肝癌病灶在门脉期增强均有不同程度的减退,与周围肝实质回声相比,分为轻度减退和明显减退两种;其中NETLM表现为轻度减退的比例(30.0%)明显高于NNETLM(4.0%)(P0.05)。结论 NETLM和NNETLM的CEUS表现有一定差异性,CEUS在对二者的鉴别诊断中有一定价值。
[Abstract]:Objective to investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of neuroendocrine source metastatic liver cancer (NETLM) and non neuroendocrine metastatic liver cancer (NNETLM). Methods a retrospective analysis was made to the CEUS images of 30 cases of NETLM and 50 cases of NNETLM confirmed by surgery or puncture pathology, and the enhancement time was recorded and evaluated. Methods and the manifestations of arterial phase (0~40s), portal phase (40~120s) and delay period (120s). Results there were different degrees of enhancement in the two groups of metastatic liver cancer, of which the enhanced time for NETLM was (44.73 + 22.70) s later than that of NNETLM (33.72 + 7.17) s (P0.05), and the enhanced mode of arterial phase of metastatic liver cancer in the two group was enhanced. There were two main types of ring-shaped and holistic enhancement, of which the ratio of NETLM to overall enhancement (93.3%) was significantly higher than that of NNETLM (56%) (P0.05). Two groups of metastatic liver cancer were reduced in varying degrees in portal vein stage, compared with the echo of peripheral liver parenchyma, which were divided into mild hypothyroidism and two kinds, of which NETLM showed mild subtraction. The proportion of the regression (30%) was significantly higher than that of NNETLM (4%) (P0.05). Conclusion the CEUS performance of NETLM and NNETLM was different, and CEUS was of certain value in the differential diagnosis of the two.

【作者单位】：复旦大学附属中山医院超声科;上海市影像医学研究所;
【基金】：国家自然科学基金项目(No.81371577,81571676)
【分类号】：R445.1;R735.7

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