CAJ | 학술논문

背景与目的：我国肝癌发病率高，原发性肝癌常在肝硬化的基础上发生，早期诊断较为困难。本研究应用实时超声造影对肝癌高危患者进行定期跟踪监测，探讨其早期发现和诊断微小肝癌的临床应用价值。方法：2011年2月-2013年11月针对320例肝癌高危患者进行定期的肝常规超声检查和追踪定位的肝超声造影检查，根据肝内病灶在超声造影不同时相的增强表现特点鉴别诊断其良恶性。结果：320例肝癌高危患者定期随访中，经肝超声造影发现和诊断微小肝细胞癌20例，并经手术病理证实，包括直径≤1.0 cm肝癌7例、1.1~2.0 cm肝癌13例。其中6例(30.0%)呈不典型的“快进同出”型表现；病灶小，灰阶超声上呈等回声是超声造影表现不典型的主要因素。结论：常规超声和超声造影对肝癌高危患者的定期跟踪监测，可早期发现微小肝癌，使患者得到及时治疗。
배경여목적：아국간암발병솔고，원발성간암상재간경화적기출상발생，조기진단교위곤난。본연구응용실시초성조영대간암고위환자진행정기근종감측，탐토기조기발현화진단미소간암적림상응용개치。방법：2011년2월-2013년11월침대320례간암고위환자진행정기적간상규초성검사화추종정위적간초성조영검사，근거간내병조재초성조영불동시상적증강표현특점감별진단기량악성。결과：320례간암고위환자정기수방중，경간초성조영발현화진단미소간세포암20례，병경수술병리증실，포괄직경≤1.0 cm간암7례、1.1~2.0 cm간암13례。기중6례(30.0%)정불전형적“쾌진동출”형표현；병조소，회계초성상정등회성시초성조영표현불전형적주요인소。결론：상규초성화초성조영대간암고위환자적정기근종감측，가조기발현미소간암，사환자득도급시치료。
Background and purpose:The incidence of liver cancer is high in China. Primary liver cancers usually occur in patients with liver cirrhosis, which is a challenge for the early diagnosis of liver cancer. Our purpose is to investigate the efifcacy of contrast-enhanced ultrasonography (CEUS) in the early identiifcation and diagnosis of small hepatocellular carcinoma (HCC) by regularly tracking and supervising the high risk population. Methods:A total of 320 high risk patients of HCC admitted in our hospital from February 2011 to November 2013 were enrolled in this prospective study. All patients underwent conventional ultrasound and hepatic CEUS. The differential diagnosis of malignant HCCs from benign ones was based on the enhancement patterns of hepatic lesions in different phases on CEUS. Results:Twenty patients were diagnosed as small HCC among 320 HCC high risk patients who were under regular surveillance using CEUS and all were pathologically conifrmed. Seven of the 20 HCC cases were smaller than 1.0 cm and 13 measured 1.1-2.0 cm. There were 6 (30.0%) HCCs presented as“early wash-in and slow wash-out”atypical pattern of HCC. The small size of the lesion and iso-echogenicity were the main factors of atypical pattern of HCC on CEUS.Conclusion:Ultrasonography and CEUS surveillance is a useful strategy for the early detection of small HCCs in high risk patients, which can help them to receive proper therapeutic management in time.