Abstract:【Objective】To contrast the value of contrast-enhanced ultrasound and magnetic resonance imaging (MRI) in the diagnosis of small hepatocellular carcinoma under the liver capsule. 【Methods】89 patients with suspected small subcapsular liver cancer in Baoji Hospital of Traditional Chinese Medicine were selected as the research subjects from July 2019 to September 2021. All patients underwent contrast-enhanced ultrasound and MRI examination, and pathological diagnosis was used as the "gold standard". The results of contrast-enhanced ultrasound and MRI, analysis of contrast-enhanced ultrasound and MRI diagnostic efficiency and consistency were recorded. 【Results】There were 95 subcapsular liver lesions in 89 patients with suspected small subcapsular liver cancer, of which 79 lesions (83.16%, 79/95) were confirmed to be small subcapsular liver cancer by surgical pathology and puncture pathological examination. The contrast-enhanced ultrasound examination showed 77 lesions (81.05%, 77/95) with "fast forward and fast exit" signs. The peak intensity (PI) of small liver cancer lesions was higher than that of benign lesions, and the rise time (RT) and peak time (PT) of small liver cancer lesions were lower than those of benign lesions (P<0.05). MRI diagnosis revealed that 75 lesions (78.95%, 75/95) showed significant signal enhancement in the arterial phase, decreased signal in the venous phase and equilibrium phase, and significantly low signal in the hepatobiliary phase. The peak value (PV), maximum ascending slope (MSI), and maximum descending slope (MSD) of small liver cancer lesions were all lower than those of benign lesions (P<0.05), and the Kep value, Ktrans value and Ve value of small liver cancer lesions were higher than those of benign lesions (P<0.05). The consistency kappa values of pathological diagnosis, contrast-enhanced ultrasound and MRI diagnosis were 0.801 and 0.789, respectively, and the consistency kappa values of contrast-enhanced ultrasound and MRI diagnosis were 0.806. 【Conclusion】Contrast-enhanced ultrasound and MRI have similar efficacy in diagnosing small subcapsular liver cancer, and the appropriate diagnostic method can be selected based on individual conditions.
杜佩, 葛欣. 超声造影与磁共振诊断肝包膜下小肝癌的临床价值[J]. 医学临床研究, 2022, 39(12): 1768-1770.
DU Pei, GE Xin. Evaluation of the Consistency Between Contrast-Enhanced Ultrasound and Magnetic Resonance in The Diagnosis of Small Subcapsular Liver Cancer. JOURNAL OF CLINICAL RESEARCH, 2022, 39(12): 1768-1770.
[1] TATEISHI H,KUROKI K,MACHIDA H,et al. Clinical applications of digital angiography with the harmonization function in body interventional radiology[J].Jpn J Radiol,2020,38(10):922-933. [2] GUPTA A,KUMAR R,YADAV H P,et al. Feasibility of 4D CT simulation with synchronized intravenous contrast injection in hepatocellular carcinoma[J].Rep Pract Oncol Radiother,2020,25(2):293-298. [3] 毛枫,袁海霞,范培丽,等. 超声造影诊断肝包膜下小肝癌的临床价值[J].中国肿瘤临床,2020,47(11):563-566. [4] REN Y,HE S,HUTTAD L,et al. An NIR-II/MR dual modal nanoprobe for liver cancer imaging[J].Nanoscale,2020,12(21):11510-11517. [5] HORVAT N,MONTI S,OLIVEIRA B C,et al. State of the art in magnetic resonance imaging of hepatocellular carcinoma[J].Radiol Oncol,2018,52(4):353-364. [6] SANGHVI T,BOYUM J,SPILSETH B,et al. MRI for hepatocellular carcinoma:a primer for magnetic resonance imaging interpretation[J].Abdom Radiol (NY),2018,43(5):1143-1151. [7] KOKUDO N,TAKEMURA N,HASEGAWA K,et al. Clinical practice guidelines for hepatocellular carcinoma:The Japan Society of Hepatology 2017 (4th JSH-HCC guidelines) 2019 update[J].Hepatol Res,2019,49(10):1109-1113. [8] 母青林. 钆贝葡胺MRI增强在肝硬化结节与小肝癌诊断鉴别中的应用[J].中国CT和MRI杂志,2020,18(4):98-100. [9] GILLIES D J.Geometrically variable three-dimensional ultrasound for mechanically assisted image-guided therapy of focal liver cancer tumors[J].Med Phys,2020,47(10):5135-5146. [10] RONOT M,PURCELL Y,VILGRAIN V. Hepatocellular carcinoma:current imaging modalities for diagnosis and prognosis[J].Dig Dis Sci, 2019,64(4):934-950. [11] LIN Z Y,FANG Y,CHEN J,et al. Feasibility and efficacy study of microwave ablation of recurrent small HCC guided by enhanced liver-specific magnetic resonance imaging contrast agent[J].Int J Hyperthermia,2020,37(1):1330-1335.