目的观察肝硬化背景下小肝细胞癌(SHCC)与不典型增生结节(DN)的CEUS灌注增强特点,探讨CEUS的鉴别诊断价值。方法对肝硬化背景下42个SHCC病灶和21个DN病灶进行术前CEUS检查,观察病灶CEUS各时相的增强水平,比较其增强模式。结果 SHCC与DN各时相的增强水平及整体增强模式差异均有统计学意义(P均〈0.05)。动脉相SHCC以高增强为主,DN以低增强为主;SHCC的增强模式主要为动脉相高增强、门脉相及延迟相呈低增强,DN的增强模式复杂多样。结论肝硬化背景下SHCC与DN有不同的CEUS灌注增强特点,CEUS有助于鉴别诊断。
Objective To investigate the perfusion features of small hepatocellular carcinoma(SHCC) and dysplastic nodules(DN) in cirrhotic livers,and to assess the value of CEUS in differential diagnosis of small HCC(SHCC) and DN.Methods Forty-two SHCC and 21 DN in cirrhotic livers were examined with CEUS before surgery.The enhanced level of all the nodules in different time phases were observed and the contrast enhancement patters were compared between SHCC and DN.Results Both the enhanced level in different time phases and contrast enhancement patters of SHCC and DN presented statistical significance(all P0.05).SHCC primarily presented hyper-enhancement,while DN primarily presented hypo-enhancement in arterial phase.The main contrast enhancement patterns in SHCC primarily were hyper-enhancement in arterial phase,hypo-enhancement in portal phase and delayed phase,while in DN was variable.Conclusion SHCC and DN in cirrhotic livers display different perfusion features on CEUS.CEUS is helpful for differential diagnosis of SHCC and DN.