超声检查53例弥漫性肝癌的临床分析.pdf

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1、世界最新医学信息文摘2013年第13卷第l6期37·论著·超声检查53例弥漫性肝癌的临床分析朱卫东(辽宁省抚顺市第四医院超声科，辽宁抚顺113000)摘要：目的探讨超声对弥漫性肝癌的诊断价值，以提高弥漫性肝癌的诊断率。方法对2010年1月至2013年1月间在我院诊断、治疗并经病理证实的53例弥漫性肝癌患者的超声图像特点及临床特征进行了回顾性总结。结果弥漫性肝癌患者肝脏体积明显增大，肝右叶最大斜径常常大于14cm；肝包膜呈高低不平的波浪状改变，肝内回声以粗大斑块、低回声小球状结节或无包膜无声晕的高回声结节弥漫分布为主；肝内管道系走行僵直、中断，走向不清；门脉内径增宽且伴有癌

2、栓形成，CDFI显示弥漫性肝癌结节周边可检出高阻力动脉血流信号。结论弥漫性肝癌虽然是原发性肝癌中较少见的肝癌类型，但是临床超声检查中如发现肝体积增大、肝脏包膜凹凸不清、肝内回声呈斑块状、边界不清的低密度结节或者无包膜无声晕的高回声结节弥漫分布时，要仔细寻找门脉有无栓子再结合临床症状及实验室检查排出结节性肝硬化诊断后，弥漫性肝癌的检出率将大大提高，值得临床推广应用。关键词：超声；弥漫性肝癌；影像特点中图分类号：R445文献标识码：ADOI：10．3969~．issn．1671．3141．2013．16．018Ultrasoundexaminationof53casesofd

3、iffusehepatoeellularcarcinomaclinicalanalysis．ZhuWei-dong(Departmentoful~sound,thefourthhospitalofFushunCity,LiaoningProvince,FushtmCLiaoningProvince,113000)ABSTRACT：ObiectiveToexplorethediagnosisvalueofultrasonographyindiffusehepatocellularcarcinoma．inordertoimprovethediagnosisofdiffuseh

4、epatocellularcarcinoma．MethodsInJanuary2010．2013inourhospita1betweenJanuaryandconfirmedbypathology,thediagnosisandtreatmentof53casesOfdifmsehepatocellularcarcinomainpatientswithultrasonicimagecharacteristicsandclinicalfeatureswereretrospectivelysummarized．ResuItDifusehepatocellula．rcarcin

5、omainpatientswithlivervolumeincreasedobviously,therightliverlobeobliquediameterbiggestoftengreaterthan14cm：Livercapsularruggedwavychange．intrahepaticechoinlowechosmallglobularnodulesornobulkvplaquescoatedhighechotuberclediffusedistributionofsilenthaloiSgivenpriorityto：Intrahepaticductsyst

6、emgoIineinterruptionofrigidityandiSnotclear；Gatepulsewidthanddiameterwithtumoremboliformed．ofaCDFIshoweddiffusehepatocellularcarcinomanodulesperiphera1arterialbloodflowsignalcanbedetectedwithhighresistance．ConclusionDifusehepatocellularcarcinomaiSararetypeoflivercancerintheprimarylivercan

7、cer,butsuchasfoundinclinicalultrasoundlivervolumeincreaselivercapsularbumpisnotclearoftheechoplaquesshapedboundaryiSnotclearintheliverlowdensitytuberousornocoatedsilenthighechotuberclediffhsedistributionofthehalos．carefullylookingforportalpresenceofemboluscombiningc