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目的探讨彩色及脉冲多普勒超声对肝癌与肝血管瘤的肝固有动脉(PHA)和肝静脉(HV)及其在瘤体内、外肝动、静脉异常供血及血流的鉴别诊断特征。方法对62例进行彩色多普勒检查,结合手术或穿刺活检病理证实。结果一般来说,肝癌肿瘤的血流多为Vmax>60cm/s,RI>0.50,而血管瘤的肿瘤血流Vmax≤60cm/s,RI≤0.50。肝癌PHA管径大于4mm,血流Vmax>70cm/s,RI>0.70,肝血管瘤PHA管径小于或等于4mm,血流速度一般不超过70cm/s,RI≤0.60。肝癌组中:HV波型几乎100%显示HV1型或HV2型,DV/SV>0.6者占97.6%,同时SV速度加快;肝血管瘤组中:肝静脉的HV波型均为HV0型,DV/SV<0.6。结论对肝癌与肝血管瘤进行正确鉴别诊断的最好方法是对肿瘤动脉和肝固有动脉的血流Vmax和RI参数、HV波型、DV/SV和PHA管径以及二维图像进行详细观测,综合判断。
Objective To investigate the differential diagnosis of hepatic and hepatic hemangiomas of hepatic and hepatic hemangiomas with color and pulsed Doppler sonography in the differential diagnosis of hepatic arterial (PHA) and hepatic veins (HV) and their abnormal hepatic artery and venous blood supply and blood flow. Methods Sixty-two patients underwent color Doppler flow imaging combined with biopsy of operation or biopsy. Results In general, the blood flow of liver cancer was Vmax> 60cm / s and RI> 0.50, while the tumor blood flow Vmax≤60cm / s and RI≤0.50. Liver PHA diameter greater than 4mm, blood flow Vmax> 70cm / s, RI> 0.70, hepatic hemangioma PHA diameter less than or equal to 4mm, blood flow velocity generally not more than 70cm / s, RI ≤ 0.60. In the group of hepatocellular carcinoma, the HV wave patterns showed HV1 or HV2 almost 100%, and 97.6% with DV / SV> 0.6, meanwhile, the speed of SV accelerated. In the hepatic hemangioma group, the HV wave patterns of HV were HV0, DV /SV<0.6. Conclusion The best method for the correct differential diagnosis of hepatocellular carcinoma and hepatic hemangioma is to observe the blood flow Vmax and RI parameters, HV wave form, diameter of DV / SV and PHA and two-dimensional images of tumor and hepatic artery accurately. Comprehensive judgment.