Ultrasonographic Characteristics and Notice of Small Hepatocellular Carcinoma Diagnosis by Color Dopplar Ultrasound
DU Jian-ku, LI Guan-hai, WANG Jun-qi, LI Ke (Interventional Center, the 150th Central Hospital of the PLA, Luoyang 471031, Henan Province, China) Abstract Objective To study the clinical value and notice of color Dopplar ultrasound in the diagnosis of small hepatocellular carcinoma (HCC). Methods The two-dimensional ultrasound and color Doppler ultrasound performances of 158 cases with small HCC were studied retrospectively, the relationship between the echo of edge, internal and side of the lumps and the peripheral blood vessel was focused on, and also the blood flow nature and hemodynamic parameters of surrounding and internal bump were paid much attention to. Results One hundred and fifty-two nidus were detected to have obvious mass effect, most of which were hypoechoic with halo around the sound. Peripheral vascular could be compressed and interrupted. The maximum lesion was 3.6 cm and the minimum one was 1.1 cm. Six nidus were not detected by color ultrasound, which were verified by CT and DSA angiography, so the total detection rate was 96.20%. For all the detected nidus, blood flow signals emerged in perifocal and internal, among which was 90.79% (138/152) for arterial blood flow, and 9.21% (14/ 152) for portal vein blood flow. Tumor size had certain relationship with blood flow velocity, the larger the neoplasm was, the higher its internal arterial blood systolic peak speed was. Six cases who was not detected, because of which, the ultrasonographic characteristics were not obvious or were under the right diazoma (covered) and other reasons. Conclusion Color Dopplar ultrasound diagnosis of small HCC has a typical ultrasonographic characteristic, which can be used as preferred imaging of small HCC diagnosis. However, blind spots of color Dopplar ultrasound diagnosis should be reduced as much as possible, and the detection of atypia ultrasonographic characteristics of small HCC should be focused on.[Chinese Medical Equipment Journal，2011，33（2）：76-77] Key words diagnosis; small HCC; detection; ultrasonography
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Clinical Medical Equipment 医 械 琦，李 珂 （解放军 150 中心医院介入中心，河南洛阳 471031）
[摘要] 目的：探讨彩超诊断小肝癌的临床价值和注意事项。 方法：总结分析 158 例小肝癌的二维及彩色多普勒超声 表现，重点分析肿块的边缘、内部及侧方回声与周围血管的关系，肿块周边与内部的血流性质，血流动力学参数。 结 果：检出的 152 例病灶具有明显团块效应，大多为低回声，周边可有声晕。 周边血管可受压、中断。 病灶最大为 3.6 cm， 最小为 1.1 cm。 有 6 例彩超未检出，后经 CT 及 DSA 造影证实，总检出率 96.20%，所检出病灶周边及内部均有血流信 号，其中 90.79%（138/152）为动脉血流，9.21%（14/152）为门静脉血流。 肿瘤体积与血流速度有一定关系，肿瘤越大，其 内部动脉血流收缩期峰值速度越高。6 例未检出者，由于超声像学特征不明显或在右膈下（被遮盖）等原因。 结论：彩超 诊断小肝癌具有较典型的声像学特征，可作为诊断小肝癌的首选影像学检查，但应尽量缩小彩超诊断盲区和重点对 声像学特征不典型的小肝癌的检测。 [关键词] 诊断；小肝癌；检测；声像学 [中国图书资料分类号] R445.1；R735.7 [文献标识码] A [文章编号] 1003-8868（2012）02-0076-02