目的:探讨超声造影(contrast-enhanced ultrasonography,CEUS)在乙肝相关肝细胞癌(hepatocellular carcinoma, HCC)高危人群中诊断约2 cm HCC的应用价值。方法2011年1月至2012年12月,我院对乙肝相关HCC高危人群进行B超筛查,其中对约2 cm肝占位的77例患者86个病灶行CEUS和增强CT (contrast-enhanced computed tomography, CECT)检查,以病理检查结果为金标准,对比分析CEUS与CECT检查诊断约2 cm HCC的敏感性、特异性和准确性。结果CEUS和CECT在诊断约2 cm HCC的敏感性、特异性、准确性分别为81.0%、88.6%、84.9%和76.2%、90.9%、83.7%,分别比较两者的差异均无统计学意义(P均〉0.05)。CEUS对CECT检查不能确定的2个病灶显示出典型的HCC增强模式,最终该2个病灶经病理诊断为HCC。结论对于乙肝相关HCC高危人群,CEUS在诊断约2 cm HCC的效能上与CECT检查一致;CEUS对乙肝相关HCC高危人群的随访及部分可疑病灶的诊断较CECT检查具有一定的优越性。
Objective To investigate the diagnostic value of CEUS for small(〈2 cm)hepatic nodules detected by surveillance ultrasound in patients infected with hepatitis B virus (HBV). Methods A total of 77 liver cirrhosis patients with 86 small hepatic nodules(〈2 cm)were examined by both CEUS and contrast-enhanced CT.Histopathology based on biopsy or surgery served as the diagnostic gold standard for comparing the sensitivity,specificity,and accuracy of CEUS and CT. Results Sensitivity,specificity,and accuracy were 81.0%,88.6%,and 84.9% for CEUS,similar to the corresponding values of 76.2%,90.9%,and 83.7% for contrast-enhanced CT.Two nodules were correctly diagnosed by CEUS but were misdiagnosed by CT. Conclusion CEUS shows similar ability as contrast-enhanced CT to characterize small nodules (〈2 cm)detected by surveillance in patients infected with hepatitis B virus. However,CEUS may be particularly helpful for diagnosing suspicious lesions and for performing follow up.