Objective To evaluate the value of contrast enhanced ultrasound (CEUS) on the diagnosis of micro hepatic lesions(≤2cm) after hepatectomy for hepatocellular carcinoma(HCC). Methods A total of 48 patients with 54 nodules on ultrasound were observed and analyzed with real time harmonic ultrasonographic imaging under a low mechanical index CEUS. All the 48 patients tested the serum levels of α- fetoprotein( AFP), and the ones with normal level of AFP performed contrastenhanced helieal computed tomography(CECT) or magnetic resonance imaging(MRI). The final diagnosis was based on interpreting of examinations with the change of AFP, CECT or MRI, and follow-up data. Results 51 nodules including 37 patients with 43 HCC and 8 patents with 8 benign nodules were correctly diag nosed by CEUS. 3 lesions in 3 cases were diagnosed as recurrence by CEUS, but their AFP increased before treatment, didn't decrease after treatment. The diagnostic accuracy of CEUS was 94.4％ (51/54).Conclusions The CEUS is valuable for early diagnosis of recurrence hepatocelluar carcinoma(RHCC), which provide a way for monitoring patients after hepatectomy for HCC.%目的 探讨超声造影对肝癌术后患者肝内微小占位病变(直径≤2 cm)的诊断价值.方法 采用低机械指数实时谐波超声造影技术,对常规超声不能确定的48例肝癌术后患者肝内的54个微小占位病变进行超声造影检查.48例患者均有近期血清甲胎蛋白(AFP)检测结果,对AFP不高的患者同时行增强CT或磁共振检查.最终将超声造影结果与治疗前后AFP的变化、增强CT或磁共振诊断、随访6个月以上的结果进行对比.结果 超声造影诊断正确51个病灶,其中复发病灶37例43个,硬化结节8例8个.3例3个超声造影诊断为复发,治疗前AFP升高,治疗后未下降.超声造影的诊断符合率为94.4%(51/54).结论 超声造影对复发性肝癌的早期诊断具有重要意义,为肝癌术后患者的动态随诊提供可靠的依据.
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