目的 探讨CEUS定量分析鉴别不同病理级别小肝癌的价值.方法 回顾性分析112例经手术切除或穿刺活检病理证实为肝细胞癌(HCC)的患者资料,单个肿瘤最大径或2个最大肿瘤最大径之和≤3 cm.将112例按病理Ed-mondson分级不同分为高分化组(n=50,Edmondson分级Ⅰ、Ⅱ级)、中分化组(n=32,Ⅲ级)及低分化组(n=30,Ⅳ级).应用Qontraxt超声定量分析软件分别测量肿瘤最大造影强度(TMAX)、肿瘤达到最大造影强度时周边组织造影强度(NT)、周边组织最大造影强度(NTMAX),并计算TMAX与NT的比值(TMAX/NT)和TMAX与NTMAX的比值(TMAX/NTMAX).记录肿瘤初次显影时间、肿瘤显影达峰时间、肿瘤廓清时间,比较3组间的差异.结果 高分化、中分化及低分化组间,TMAX、TMAX/NTMAX和肿瘤廓清时间差异有统计学意义(P均＜0.05).低分化组TMAXTTMAX/NTMAX最高、肿瘤廓清时间最短,高分化组TMAX和TMAX/NTMAX最低、肿瘤廓清时间最长.3组间NT、NTMAX、TMAX/NT、肿瘤初次显影时间、肿瘤显影达峰时间差异均无统计学意义(P均＞0.05).结论 CEUS定量分析有助于鉴别不同病理级别小肝癌.%Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.
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