胆管细胞癌与不同分化程度肝细胞癌CEUS特征的对比研究

发布时间：2018-05-01 03:10

本文选题：胆管癌 + 癌　；参考：《中国医学影像技术》2017年05期

【摘要】：目的比较肝内胆管细胞癌(ICC)和不同分化程度肝细胞癌(HCC)CEUS表现对ICC和不同分化程度HCC的鉴别诊断价值。方法回顾性分析经病理证实的34例ICC(ICC组)和136例不同分化程度的HCC患者高、中、低分化(HCC组)的常规超声及CEUS表现,并评价CEUS始退时间对ICC的诊断效能。结果 ICC组在门静脉早期开始消退的比例(24/34,70.59%)均高于各HCC组,在门静脉中期开始消退的比例(0/34)和在门静脉晚期/延迟期开始消退的比例(4/34,11.76%)均低于中、高分化HCC组,差异均有统计学意义(P均0.008)。低分化HCC组在门静脉中期开始消退的比例(16/41,39.02%)高于高分化HCC组(P0.008)。CEUS诊断ICC的敏感度、特异度、阳性预测值、阴性预测值、准确率、阳性似然比及阴性似然比分别为82.35%(28/34)、91.18%(124/136)、70.00%(28/40)、95.38%(124/130)、89.41%(152/170)、9.4、0.2。ICC及低、中、高分化HCC组病灶CEUS始增时间分别为(13.03±3.49)s、(13.80±3.04)s、(14.89±4.12)s、(16.00±3.38)s,差异有统计学意义(F=4.369,P0.05),ICC组始增时间早于高分化HCC组(P0.05)。结论不同分化程度HCC和ICC的CEUS表现存在差异,CEUS对其鉴别诊断有一定的参考价值。
[Abstract]:Objective to compare the differential diagnostic value of ICC and HCC with different differentiation degree of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods the conventional ultrasound and CEUS findings of 34 cases of pathologically proved HCC and 136 cases of HCC with different differentiation were analyzed retrospectively, and the diagnostic efficacy of the onset time of CEUS for ICC was evaluated. Results in ICC group, the rate of extinction in early portal vein (24 / 34) was higher than that in other HCC groups (0 / 34) and in late portal vein / delayed phase (4 / 34 / 11.76g), respectively, which was significantly lower than that in well-differentiated HCC group. The difference was statistically significant (P = 0.008). The proportion of the low-differentiated HCC group that began to fade in the middle of the portal vein was 16 / 41 / 39.02) higher than that in the well-differentiated HCC group (P0.008N. CEUS). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio and negative likelihood ratio were 82.35% 281.18124P 1360.The ratio of positive likelihood to negative likelihood was 82.35%, respectively. In the well-differentiated HCC group, the onset time of CEUS was 13.03 卤3.49s (13.80 卤3.04s) and 14.89 卤4.12m (16.00 卤3.38g), respectively. The difference was statistically significant (P < 0.01). The time of initiation of CEUS in the well-differentiated HCC group was earlier than that in the well-differentiated HCC group (P 0.05). Conclusion there are differences in CEUS manifestations between HCC and ICC with different degrees of differentiation. CEUs has some reference value in differential diagnosis.
【作者单位】：中南大学湘雅医院超声影像科;
【分类号】：R445.1;R735.8

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