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目的通过彩色多普勒超声观察肝癌患者血流分布及血流参数,以评价彩色多普勒超声对原发性肝癌、转移性肝癌的诊断价值。方法收集肝癌患者174例,其中原发性肝癌44例,转移性肝癌130例(肺癌26例,乳腺癌18例,胃癌30例,结肠癌18例,胰腺癌8例,肝内转移30例)。通过彩色多普勒超声检测肿块内部及其周边血流分布、阻力指数、峰值血流速度及门静脉血流速度。结果原发性肝癌组与转移性肝癌组患者的肿块血流情况均随着瘤体的增大而增加,血流检出率升高,块状型血流检出率为100%。原发性肝癌组的小肝癌血流检出率(85%)明显高于转移性肝癌组(42%),差异有统计学意义(χ2=39.888,P<0.01)。转移性肝癌的平均阻力指数、峰值血流速度均较原发性肝癌低,门静脉血流速度较原发性肝癌高,差异均有统计学意义(t值分别为4.750、11.132、5.536,P<0.01)。结论彩色多普勒超声通过病灶血流分布及血流参数对原发性肝癌和转移性肝癌具有一定的诊断价值。
Objective To observe the distribution of blood flow and blood flow parameters in patients with hepatocellular carcinoma by color Doppler ultrasound in order to evaluate the diagnostic value of color Doppler ultrasound in primary liver cancer and metastatic liver cancer. Methods Totally 174 hepatocellular carcinoma patients were collected, including 44 primary hepatocellular carcinoma, 130 metastatic liver cancer (26 lung cancer, 18 breast cancer, 30 gastric cancer, 18 colon cancer, 8 pancreatic cancer and 30 liver metastasis) . Color flow distribution, resistance index, peak blood flow velocity and portal vein blood flow velocity were detected by color Doppler sonography in and around the tumor. Results The mass flow of tumor in primary liver cancer group and metastatic liver cancer group increased with the increase of tumor volume, and the detection rate of blood flow increased. The detection rate of massive blood flow was 100%. The detection rate of small hepatocellular carcinoma (85%) in primary hepatocellular carcinoma was significantly higher than that in metastatic hepatocellular carcinoma (42%) (χ2 = 39.888, P <0.01). The average resistance index and peak blood flow velocity of metastatic HCC were lower than those of primary liver cancer and portal vein blood flow velocity was higher than that of primary liver cancer (t = 4.750, 11.132, 5.536, P < 0.01). Conclusion The color Doppler ultrasound through the lesion blood flow distribution and blood flow parameters of primary liver cancer and metastatic liver cancer has a certain diagnostic value.