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超声/CT融合成像技 术在常规超声难显 示的肝癌中的应用*

作者:蒋泽波 谭燕玲 巫景潜 邓建国

所属单位:广东省英德市人民医院超声科(广东 清远 513000)

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摘要

目的 探究超声/电子计算机断层 扫描(CT)融合成像技术在常规超声难显 示的肝癌中的应用效果。方法 回顾性分 析我院经CT清晰显示而二维超声未提示的 102例肝脏局灶性病变患者临床资料。记 录102例患者病理结果,并分析低年资医 师(工作年限<3年)及高年资医师(工作年 限>10年)应用超声/CT融合成像技术的融 合情况及对肝癌的诊断效果。结果 102 例肝脏局灶性病变患者中原发性肝癌86 例,肝血管瘤10例,肝血管内皮细胞瘤5 例,肝结节增生1例。低年资医师及高年 资医师融合成功率均为100%,且其对位误 差比较,差异无统计学意义(P>0.05)。 低年资医师与高年资医师超声/CT融合成 像诊断正确率比较,差异无统计学意义(P >0.05)。结论 超声/CT融合成像成功率 高,且不受人为因素的影响,还能辅助诊 断原发性肝癌,具有实时、简便、稳定等 优点。

Objective To explore the application effects of ultrasound/computed tomography (CT) fusion imaging in the treatment of liver cancer difficult to display by conventional ultrasound. Methods The clinical data of 102 patients with focal hepatic lesions were visualized clearly by CT and not indicated by two-dimensional ultrasound were analyzed retrospectively. The pathological results of 102 patients were recorded, and the fusion conditions of the junior physicians (working years <3 years) and the senior physicians (working years >10 years) who used ultrasound/CT fusion imaging technique and the diagnostic effects of liver cancer were analyzed. Results Among 102 patients with focal hepatic lesions, there were 86 cases of primary liver cancer, 10 cases of hepatic hemangioma, 5 cases of hepatic vascular endothelial cell tumor and 1 case of liver nodular hyperplasia. The fusion success rates of the junior physicians and the senior physicians both were 100%, and there was no statistically significant difference (P>0.05). There was no significant difference in the diagnostic accuracy of ultrasound/CT fusion imaging between the junior physicians and the seniorphysicians (P>0.05). Conclusion Ultrasound/CT fusion imaging has high success rate and was not affected by human factors. And it can also assist in the diagnosis of primary liver cancer, and it has the advanteges of real-time, simple and stable.

【关键词】超声;CT;融合成像;肝癌; 肝脏局灶性病变

【中图分类号】R73;R44

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2019.03.027

前言

肝癌为我国常见恶性肿瘤,手术切除及肝移植为临床根治性治 疗手段[1]。另外,随着我国微创技术的飞速发展,射频消融也逐渐应 用于原发性肝癌治疗中,可在根治性去除肿瘤的同时,降低肝功能损 伤,具有较好疗效及较高安全性[2]。然而,射频消融等微创治疗目前 仅适用于直径≤5cm的原发性肝癌,对于较大的原发性肝癌多采用开 腹切除术,以保证其根治性,但手术创伤大,患者术后恢复较慢。因 此,准确检出小肝癌有其必要性与重要性。超声及电子计算机断层扫 描(CT)均为临床常见恶性肿瘤诊断方法,超声具有实时、高效等优 点,但易受胃肠气体等因素干扰,对小肿瘤的漏诊率较高;CT虽然具 有良好的空间分辨率,但实时性相对较差,且具有电离辐射,不建议 短期内多次检查[3]。而超声/CT融合成像则能利用磁定位技术将超声的 实时性与CT的空间分辨力结合,达到实时显示清晰病灶的目的[4]。基 于此,本研究回顾性分析我院经CT清晰显示而二维超声未提示的102例 肝脏局灶性病变患者临床资料,以评估超声/CT融合成像对其诊断效 果,现报告如下。