时间-强度曲线对肝脏占位性病变的诊断价值

王惠; 南彩玲; 马苏美; 杨东红

doi:10.3969/j.issn.1001-5256.2014.11.026

时间-强度曲线对肝脏占位性病变的诊断价值

DOI: 10.3969/j.issn.1001-5256.2014.11.026

兰州大学第一医院超声科

基金项目:

甘肃省消化系统肿瘤重点实验室开放课题(lzujbky-2011-t03-19)；

详细信息

中图分类号: R735.7;R445.1
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出版历程
- 收稿日期: 2013-11-06
- 出版日期: 2014-11-20

Diagnostic value of time-intensity curve for hepatic space-occupying lesions

Department of Ultrasound, The First Hospital of Lanzhou University

Research funding:

摘要

摘要:
目的探讨超声造影（CEUS）及时间-强度曲线（TIC）对甲胎蛋白（AFP）阴性肝细胞癌（HCC）、AFP阳性HCC和肝血管瘤的诊断价值。方法选取2012年10月至2013年10月临床确诊的24例AFP阴性HCC、48例AFP阳性HCC和76例肝血管瘤患者,对3组病灶分别进行常规超声、CEUS和TIC分析,采用χ2检验比较3组的CEUS表现,采用方差分析,比较3组的TIC指标。结果 AFP阴性HCC与血管瘤的动脉期和实质期有统计学差异（χ2=39.4,P=0.001;χ2=78.9,P=0.001）,AFP阳性HCC与血管瘤的动脉期和实质期差异有统计学意义（χ2=50.6,P=0.001;χ2=89.7,P=0.001）,AFP阴性HCC、AFP阳性HCC动脉期和实质期差异无统计学意义（χ2=0.036,P=0.85;χ2=0.22,P=0.643）;AFP阴性HCC、AFP阳性HCC和肝血管瘤峰值时间（TP）分别是（27.52±4.11）、（28.28±4.09）和（50.42±5.32）s,峰值强度（peak）分别是（49.52±4.31）%、（50.20±4.37）%和（47.83...
- 癌,肝细胞 /
- 血管瘤 /
- 超声造影 /
- 甲胎蛋白类
Abstract:
Objective To analyze the diagnostic values of contrast- enhanced ultrasound (CEUS) and time- intensity curve (TIC) for alpha- fetoprotein (AFP) - negative hepatocellular carcinoma ( HCC) , AFP- positive HCC, and hepatic hemangioma. Methods Patients with a confirmed diagnosis from October 2012 to October 2013 were divided into AFP- negative HCC group (24 patients) , APP- positive HCC group (48 patients) , and hepatic hemangioma group (76 patients) . Routine ultrasound, CEUS, and TIC analysis were performed on the three groups. CEUS findings and TIC indices of the three groups were compared using χ2test and independent- samples t test, respectively. Results There were significant differences in the CEUS findings during arterial and parenchymal phases between the AFP- negative HCC group and hemangioma group (χ2= 39. 4, P = 0. 001; χ2= 78. 9, P = 0. 001) , as well as between the AFP- positive HCC group and hemangioma group (χ2= 50. 6, P = 0. 001; χ2= 89. 7, P = 0. 001) , but no significant differences were observed in the CEUS findings during the same two phases between the AFP- negative HCC and AFP- positive HCC group (χ2= 0. 036, P = 0. 85; χ2= 0. 22, P = 0. 643) .The time to peak (TP) , peak intensity, area under the ROC curve (AUC) , and mean transit time (MTT) for the AFP- negative HCC group were 27. 52 ± 4. 11 s, 49. 52% ± 4. 31%, 1527. 20 ± 80. 37% s, and 78. 71 ± 3. 26 s, respectively, versus 28. 28 ± 4. 09 s, 50. 20% ± 4. 37%, 1725. 08 ± 78. 46% s, and 79. 21 ± 3. 32 s, respectively, for the AFP- positive HCC group, as well as 50. 42 ± 5. 32 s, 47. 83% ± 4. 29%, 1613. 44 ± 76. 37% s, and 79. 86 ± 3. 10 s, respectively, for the hemangioma group; there were significant ofifferences in TP among the three groups (F = 568. 63, P = 0. 001) , there were no significant differences in peak intensity, AUC and MTT among the three groups ( F =0. 245, 0. 645, 0. 860, P > 0. 05) . there were significant differences in TP between the AFP- negative HCC group and hemangioma group (P= 0. 001) , as well as between the AFP- positive HCC group and hemangioma group (P =0. 001) , but no significant difference in TP was observed between the AFP- negative HCC group and AFP- positive HCC group. Conclusion AFP- negative HCC ( or AFP- positive HCC) and hepatic hemangioma can be diagnosed differentially by CEUS findings and TP. A combination of the two examinations can improve the diagnostic value for benign and malignant liver lesions and increase the detection rate of AFP- negative HCC.
- carcinoma, hepatocellular /
- hemangioma /
- contrast-enhanced ultrasound /
- alpha-fetoproteins

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