超声造影与增强CT检查诊断小于2 cm肝细胞癌的对比研究

摘要

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.%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。