Sonazoid超声造影与MRI增强扫描诊断肝硬化背景下最大径≤3 cm肝细胞癌的对比研究OA
A comparative study of Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI in diagnosis of hepatocellular carcinoma with a maximum diameter of≤3 cm in liver cirrhosis
目的:分析Sonazoid超声造影与MRI增强扫描对肝硬化背景下最大径≤3 cm肝细胞癌的诊断效果,为临床诊疗提供参考.方法:选取肝硬化背景下肝内占位性病变患者55例共62个病灶(最大径均≤3.0 cm),其中肝细胞癌40个(恶性组),良性病灶22个(良性组,血管瘤9个,增生结节10个,再生结节3个).2组均行Sonazoid超声造影及MRI增强扫描,并以组织病理学或临床随访结果为金标准,比较Sonazoid超声造影与MRI增强扫描诊断最大径≤3 cm肝细胞癌的准确率、敏感度和特异度,并分析2种方法的诊断一致性.结果:Sonazoid超声造影示恶性组动脉期以高增强为主,门静脉期与延迟期均呈等或低增强,Kupffer期以低增强为主;良性组动脉期以高增强为主,门静脉期、延迟期、Kupffer期均以等增强为主;2组间各扫查时相增强特征比较,差异均有统计学意义(均P<0.01).Sonazoid超声造影诊断肝细胞癌的准确率、敏感度和特异度分别为93.5%(58/62)、92.5%(37/40)和95.5%(21/22);MRI增强扫描的诊断准确率、敏感度和特异度分别为91.9%(57/62)、95.0%(38/40)和86.4%(19/22);2种检查方法差异均无统计学意义(均P＞0.05).2种方法诊断肝细胞癌的一致性较好(K=0.93).结论:Sonazoid超声造影及MRI增强扫描对肝硬化背景下最大径≤3 cm肝细胞癌的诊断效能相近,均有较高的临床应用价值.
Objective:To analyze the diagnostic efficacy of Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI in hepatocellular carcinoma with a maximum diameter of≤3 cm in patients with liver cirrhosis,and to provide a reference for clinical diagnosis and treatment.Methods:A total of 55 patients with intrahepatic space-occupying lesions in the background of liver cirrhosis were selected,with a total of 62 lesions,the maximum diameter of which was≤3.0 cm.Among them,40 lesions were hepatocellular carcinomas(malignant group),and 22 were benign lesions(benign group).All patients underwent Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI examinations.The results of histopathology or clinical follow-up were taken as the gold standard.The accuracy,sensitivity,and specificity of Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI in diagnosing hepatocellular carcinomas with a maximum diameter of≤3 cm were compared,and the diagnostic consistency of the two methods was analyzed.Results:Sonazoid contrast-enhanced ultrasound showed that in the malignant group,the lesions presented mainly with high enhancement during the arterial phase,equal or low enhancement during the portal vein and delayed phases,and low enhancement during the Kupffer phase,while in the benign group,the lesions presented mainly with high enhancement during the arterial phase,and equal enhancement during the portal vein phase,delayed phase and Kupffer phase.The comparison of enhancement characteristics in each phase between the two groups showed statistically significant differences(all P<0.01).The accuracy,sensitivity and specificity of Sonazoid contrast-enhanced ultrasound in diagnosing hepatocellular carcinoma were 93.5%(58/62),92.5%(37/40),and 95.5%(21/22),respectively,while those of contrast-enhanced MRI were 91.9%(57/62),95.0%(38/40),and 86.4%(19/22),and the differences were not statistically significant(all P>0.05),and the consistency of the two methods in diagnosing hepatocellular carcinoma was high(K=0.93).Conclusions:The diagnostic efficacy of Sonazoid contrast-enhanced ultrasound and contrast-enhanced MRI for hepatocellular carcinoma with a maximum diameter of≤3 cm in patients with liver cirrhosis is similar,and both have high clinical application value.
高志玲;袁杰;何峥;梅和平;雷洁雯;陈薇;李胜;吴凡;高月求;黄凌鹰;朱晓骏
上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院放射科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院超声医学科,上海 201203上海中医药大学附属曙光医院肝病科,上海 201203上海中医药大学附属曙光医院肝病科,上海 201203上海中医药大学附属曙光医院肝病科,上海 201203
医药卫生
超声造影Sonazoid磁共振成像肝硬化癌,肝细胞
Contrast-enhanced ultrasoundSonazoidMagnetic resonance imagingLiver cirrhosisCarcinoma,hepatocellular
《中国中西医结合影像学杂志》 2026 (3)
268-272,5
上海中医药大学预算内项目(2021LK086).
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