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二维超声、超声造影与肝细胞癌微血管侵犯的相关性研究。

Study on correlation between two-dimensional ultrasound, contrast-enhanced ultrasound and microvascular invasion in hepatocellular carcinoma.

机构信息

Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, Gansu, China.

出版信息

Clin Hemorheol Microcirc. 2022;80(2):97-106. doi: 10.3233/CH-211190.

Abstract

OBJECTIVE

To explore the correlation between two-dimensional ultrasound (2D-US), contrast-enhanced ultrasound (CEUS) and microvascular invasion (MVI) in hepatocellular carcinoma (HCC).

METHODS

In this retrospective study, 56 patients with surgically pathologically confirmed HCC lesions were included. Patients were classified according to the presence of MVI: MVI positive group (n = 17) and MVI negative group (n = 39). 2D-US and CEUS examinations were performed within two weeks before surgery. The 2D-US and CEUS features were analyzed for correlation with MVI. Statistically significant parameters of ultrasound characteristic were scored, and the results of the scores were analyzed by ROC curve.

RESULTS

There were statistically significant differences in tumor shape, boundary, capsule, CEUS portal phase and delayed phase enhancement pattern, time to wash out, and tumor margin after enhancement (P < 0.05), while there were no statistically significant differences in tumor location and size, CEUS arterial phase enhancement pattern, initial time, time to peak, and peritumor enhancement (P > 0.05). When diagnosing the presence of MVI in HCC patients with cut-off value of the score combined 2D-US and CEUS features≥3, the maximum Jorden index was 0.58, and its diagnostic sensitivity and specificity were 94.10% and 64.1%, respectively, meaning that the total score≥3 was highly suspicious of the presence of MVI.

CONCLUSIONS

2D-US and CEUS are feasible methods for preoperative prediction of MVI in HCC, and can provide some theoretical basis for individualized clinical treatment.

摘要

目的

探讨二维超声(2D-US)、超声造影(CEUS)与肝细胞癌(HCC)微血管侵犯(MVI)的相关性。

方法

本回顾性研究纳入了 56 例经手术病理证实的 HCC 病变患者。根据是否存在 MVI 将患者分为 MVI 阳性组(n=17)和 MVI 阴性组(n=39)。所有患者均在术前两周内行 2D-US 和 CEUS 检查。分析 2D-US 和 CEUS 特征与 MVI 的相关性。对超声特征的统计学显著参数进行评分,并通过 ROC 曲线分析评分结果。

结果

肿瘤形态、边界、包膜、CEUS 门脉期和延迟期增强模式、达峰时间、廓清时间以及增强后肿瘤边缘等方面差异有统计学意义(P<0.05),肿瘤位置、大小、CEUS 动脉期增强模式、起始时间、达峰时间及肿瘤周围强化等方面差异无统计学意义(P>0.05)。当联合 2D-US 和 CEUS 特征的评分值截断值为≥3 时,诊断 HCC 患者 MVI 的存在的最大 Jordan 指数为 0.58,诊断的灵敏度和特异度分别为 94.10%和 64.1%,这意味着总评分≥3 高度提示存在 MVI。

结论

2D-US 和 CEUS 是术前预测 HCC 中 MVI 的可行方法,可以为个体化临床治疗提供一些理论依据。

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