超声造影在小肝癌（≤2 cm）早期诊断中的临床价值

StephenW

超声造影在小肝癌（≤2 cm）早期诊断中的临床价值
奇美 1 , 美玉 1 , 琼 晨 2
隶属关系
隶属关系

    1
    上海徐汇大华医院超声科，上海 200237
    2
    上海徐汇大华医院放射科，上海 200237 [email protected]。

    PMID：36157793 PMCID：PMC9453369 DOI：10.12998/wjcc.v10.i24.8525

抽象的

背景：肝细胞癌（HCC）是最常见的原发性肝脏恶性肿瘤。对比增强超声 (CEUS) 在超声过程中使用对比微泡，可以检测和表征恶性肝局灶性病变，其诊断准确性远高于传统超声；然而，很少有报道关注 CEUS 增强模式用于诊断小于 2 cm 的 HCC。

目的：探讨超声造影在早期发现高危小肝癌中的临床价值。

方法：回顾性分析2007年1月至2021年12月在徐汇大华医院定期随访的395例HCC高危结节患者632个。采用常规超声结合CEUS分析良恶性结节的回声、大小、位置、增强特征，以及不同直径HCC的增强方法。

结果：随访率和持续时间分别为92.15%（364/395）和51.28±45.09个月。常规超声联合 CEUS 显示 65 个（11.80%）结节随访诊断为 HCC，19 个（3.45%）发育不良结节和 467 个（84.75%）良性肝硬化增生结节。 65例确诊HCC中，低回声结节转化40例（61.54%），高回声结节转化9例（13.85%），等回声结节转化16例（24.62%）。肝硬化结节、发育不良结节和 HCC 结节在每个阶段的 CEUS 特征存在显着差异。 ≤ 1 cm 的结节与 1-2 cm 的结节在增强模式上存在显着差异。 HCC结节越小，造影剂开始冲洗越晚，造影增强持续时间越长。

结论：常规超声联合 CEUS 可以识别小 HCC，有助于监测早期诊断为 HCC 的患者。 ≤ 1 cm 的结节与 1-2 cm 的结节在增强模式上存在显着差异。

关键词：癌；对比增强超声检查；诊断成像；肝细胞。

©作者 2022。由百视登出版集团有限公司出版。保留所有权利。
利益冲突声明

利益冲突声明：陈博士报告国家自然科学基金非财政支持、上海市名医学术经验与研究室建设项目个人费用、控制与清除临床研究个人费用在研究进行期间，中医对乙型肝炎表面抗原的研究。

StephenW

Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)
Qi Mei  1 , Mei Yu  1 , Qiong Chen  2
Affiliations
Affiliations

    1
    Department of Ultrasound, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China.
    2
    Department of Radiology, Shanghai Xuhui Dahua Hospital, Shanghai 200237, China. [email protected].

    PMID: 36157793 PMCID: PMC9453369 DOI: 10.12998/wjcc.v10.i24.8525

Abstract

Background: Hepatocellular carcinoma (HCC) is the most common type of primary liver malignancy. Contrast-enhanced ultrasound (CEUS) uses contrast microbubbles during ultrasound, allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound; however, there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.

Aim: To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.

Methods: A total of 395 patients with 632 nodules at high risk of HCC, who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021, were retrospectively examined. Conventional ultrasonography combined with CEUS was adopted to analyze the echo, size, location, and enhancement characteristics of benign and malignant nodules, as well as the enhancement methods for HCC with different diameters.

Results: The follow-up rate and duration were 92.15% (364/395) and 51.28 ± 45.09 mo, respectively. Conventional ultrasonography combined with CEUS revealed 65 (11.80%) nodules with a follow-up diagnosis of HCC, 19 (3.45%) dysplastic nodules, and 467 (84.75%) benign cirrhotic hyperplastic nodules. Among 65 cases of confirmed HCC, 40 (61.54%) were transformed from hypoechoic nodules, 9 (13.85%) from hyperechoic nodules, and the remaining 16 (24.62%) from isoechoic nodules. Significant differences in CEUS characteristics were found among cirrhotic nodules, dysplastic nodules, and HCC nodules at each phase. Significant differences in the enhancement mode were observed between nodules ≤ 1 cm and those 1-2 cm. The smaller the HCC nodule, the later the contrast agent began to flush and the longer the duration of contrast enhancement.

Conclusion: Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC. Significant differences in the enhancement mode are noted between nodules ≤ 1 cm and those 1-2 cm.

Keywords: Carcinoma; Contrast-enhanced ultrasonography; Diagnostic imaging; Hepatocellular.

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Conflict of interest statement

Conflict-of-interest statement: Dr. Chen reports non-financial support from National Natural Science Foundation of China, personal fees from the Academic Experience and Research Workshop Construction Project of Shanghai Famous TCM Doctors, personal fees from the Clinical Study on Control and Clearance of Hepatitis B Surface Antigen by Traditional Chinese Medicine, during the conduct of the study.

StephenW

https://doi.org/10.12998/wjcc.v10.i24.8525