CAJ | 학술논문

目的对慢性乙肝并发小肝癌进行超声动态观察,探讨乙肝并发小肝癌的发展规律以及超声在慢性乙肝肝内病变进展中的诊断价值.方法采用前瞻性研究方法对实验室检查报告表面抗原(HBsAg)、核心抗体(HBcAb)、e抗原(HBeAg)均阳性的122例慢性乙肝患者进行肝二维超声检查、三维超声重建,分析声像图特点.穿刺活检后,对肝内结节二维、三维超声检出率进行比较.结果 122例患者中并发小肝癌34例.从肝纤维化发展为肝硬化时间平均为(6.30±2.31)年,肝硬化发展为肝癌时间平均为(8.01±2.10)年.三维超声能较清晰地显示肝内增生结节、小肝癌形状及与周边肝组织的关系,三维超声对小肝癌的检出数较二维超声明显增多,而对肝硬化增生结节的检出数两者比较差异无统计学意义.结论应用超声动态观察慢性乙肝肝实质回声改变能早期发现肝内结节性病变,三维超声多切面、多角度检查可提高小肝癌的诊断准确性.
목적 대만성을간병발소간암진행초성동태관찰,탐토을간병발소간암적발전규률이급초성재만성을간간내병변진전중적진단개치.방법 채용전첨성연구방법 대실험실검사보고표면항원(HBsAg)、핵심항체(HBcAb)、e항원(HBeAg)균양성적122례만성을간환자진행간이유초성검사、삼유초성중건,분석성상도특점.천자활검후,대간내결절이유、삼유초성검출솔진행비교.결과 122례환자중병발소간암34례.종간섬유화발전위간경화시간평균위(6.30±2.31)년,간경화발전위간암시간평균위(8.01±2.10)년.삼유초성능교청석지현시간내증생결절、소간암형상급여주변간조직적관계,삼유초성대소간암적검출수교이유초성명현증다,이대간경화증생결절적검출수량자비교차이무통계학의의.결론 응용초성동태관찰만성을간간실질회성개변능조기발현간내결절성병변,삼유초성다절면、다각도검사가제고소간암적진단준학성.
Objective To dynamically observe the developing process and characteristics of the chronic intra-hepatic hyperplastic nodule to small hepatoma with ultrasound,and to evaluate the value of ultrasound in the diagnosis of small hepatoma.Methods One hundred twenty-two chrome hepatitis cases with HBsAg(+),HBcAb(+)and HBeAg(+)were prospectively examined by two-dimensional ultrasound and three-dimensional reconstruction.Characteristics and diagnostic accuracy of two-dimensional ultrasound and three-dimensional reconstruction were compared with the results of hepatic biopsy.Results Thirty-four of 122 patients developed small hepatoma.The duration between hepatic fibrosis and liver cirrhosis was (6.30±2.31)years,and time of hepatoma changed from liver cirrhosis was (8.01±2.10) years.The intrahepatic hyperplastic nodule,shape of small hepatoma and relationship between tumor and ambient tissue were displayed clearly with three-dimensional ultrasound,and the number of detection with threedimensional ultrasound was much higher than that of two-dimensional ultrasound significantly.Conclusions Dynamic ultrasound examination of the echogenicity change of chronic hepatic lesion caused by HBV is useful for early detection of small intra-hepatic nodule,three-dimensional ultrasound reconstruction may enhance the accuracy in diagnosing small hepatoma.