基于西甲硅油的胃部超声造影在胆管细胞癌中的诊断价值
|
摘要
目的探讨基于西甲硅油的胃部超声造影在胆管细胞癌中的诊断价值。方法采用回顾性研究方法,选择胆管细胞癌患者61例作为胆管癌组,同期选择肝细胞癌患者60例作为肝癌组。2组患者都进行胃部超声造影,记录造影效果与诊断价值。结果 2组患者的超声造影图像清晰度都为2级与3级,对比差异无统计学意义(P> 0. 05)。胆管癌组患者动脉期增强多表现为不均匀低增强和均匀高增强,与肝癌组对比差异有统计学意义(P <0. 05)。胆管癌组患者病灶部位造影50 s、90 s和150 s的平均灰度值都低于肝癌组(P <0. 05)。在121例患者中,超声造影诊断为胆管细胞癌63例,肝细胞癌58例,其诊断的敏感性与特异性为100. 0%和96. 7%。结论基于西甲硅油的胃部超声造影在胆管细胞癌中的应用具有很高的诊断敏感性与特异性,成像清晰度高,有利于与肝细胞癌进行鉴别诊断。
Objective To evaluate the diagnostic value of gastric contrast enhanced ultrasound( CEUS) based on siloxane in cholangiocarcinoma. Methods A retrospective study was conducted to select 61 patients with cholangiocarcinoma as the cholangiocarcinoma group and 60 patients with hepatocellular carcinoma as the liver cancer group. Gastric contrast-enhanced ultrasonography was performed in both groups to record the effect and diagnostic value of contrast-enhanced ultrasonography. Results The resolution of ceus images in both groups was level 2 and level 3,with no statistically significant difference( P > 0. 05). The arterial phase enhancement of patients in the cholangiocarcinoma group was mainly manifested as non-uniform low-intensity enhancement and uniform high-intensity enhancement,and the difference between the 2 groups was statistically significant( P <0. 05). The mean gray scale values of 50 s,90 s and 150 s in the foci of patients in the cholangiocarcinoma group were lower than those of the liver cancer group( P < 0. 05). Among the 121 patients,there were 63 cases of cholangiocarcinoma and 58 cases of hepatocellular carcinoma diagnosed by contrast-enhanced ultrasonography,with the sensitivity and specificity of 100. 0% and96. 7% respectively. Conclusion Gastric contrast-enhanced ultrasonography based on simethicone oil has a high diagnostic sensitivity and specificity in cholangiocarcinoma with a high imaging definition,which is conducive to the differential diagnosis of hepatocellular carcinoma.
Objective To evaluate the diagnostic value of gastric contrast enhanced ultrasound( CEUS) based on siloxane in cholangiocarcinoma. Methods A retrospective study was conducted to select 61 patients with cholangiocarcinoma as the cholangiocarcinoma group and 60 patients with hepatocellular carcinoma as the liver cancer group. Gastric contrast-enhanced ultrasonography was performed in both groups to record the effect and diagnostic value of contrast-enhanced ultrasonography. Results The resolution of ceus images in both groups was level 2 and level 3,with no statistically significant difference( P > 0. 05). The arterial phase enhancement of patients in the cholangiocarcinoma group was mainly manifested as non-uniform low-intensity enhancement and uniform high-intensity enhancement,and the difference between the 2 groups was statistically significant( P <0. 05). The mean gray scale values of 50 s,90 s and 150 s in the foci of patients in the cholangiocarcinoma group were lower than those of the liver cancer group( P < 0. 05). Among the 121 patients,there were 63 cases of cholangiocarcinoma and 58 cases of hepatocellular carcinoma diagnosed by contrast-enhanced ultrasonography,with the sensitivity and specificity of 100. 0% and96. 7% respectively. Conclusion Gastric contrast-enhanced ultrasonography based on simethicone oil has a high diagnostic sensitivity and specificity in cholangiocarcinoma with a high imaging definition,which is conducive to the differential diagnosis of hepatocellular carcinoma.
引文
[1]Namikawa T,Fujisawa K,Munekage E,et al.Epstein-Barr virus-associated early gastric carcinoma with lymphoid stroma,accompanied with lymph node metastasis[J].Mol Clin Oncol,2018,8(4):561-566.
[2]肖来华,尉继伟.胆总管囊肿26例影像诊断及治疗分析[J].肿瘤研究与临床,2015,27(4):270-272.
[3]Wang L,Wang X,Kou H,et al.Comparing single oral contrast-enhanced ultrasonography and double contrast-enhanced ultrasonography in the preoperative Borrmann classification of advanced gastric cancer[J].Oncotarget,2017,9(9):8716-8724.
[4]谢海琴,魏妮娅,陈芸,等.西甲硅油在提高胃超声造影检查中的应用价值[J].临床超声医学杂志,2015,17(10):696-698.
[5]Perlaza P,Ortín J,Pagès M,et al.Should 18F-FDG PET/CT be routinely performed in the clinical staging of locally advanced gastric adenocarcinoma?[J].Clin Nucl Med,2018,43(6):402-410.
[6]Neciu CV,Puia IC,Badea AF,et al.Greyscale and contrast enhanced ultrasonography for characterization of gastric malignant tumors[J].Med Ultrason,2018,1(1):8-13.
[7]邵丽春,周秀丽,郭庆,等.西甲硅油乳剂在胃超声造影观察中的价值[J].中国临床实用医学,2016,7(4):68-69.
[8]Zhang K,Du X,Yu K,et al.Application of novel targeting nanoparticles contrast agent combined with contrast-enhanced computed tomography during screening for earlyphase gastric carcinoma[J].Exp Ther Med,2018,15(1):47-54.
[9]Furuta A,Isoda H,Ohno T,et al.Left gastric vein visualization with hepatopetal flow information in healthy subjects using non-contrast-enhanced magnetic resonance angiography with balanced steady-state free-precession sequence and time-spatial labeling inversion pulse[J].Korean J Radiol,2018,19(1):32-39.
[10]王华,汪涛,汤礼军.介入影像医学技术在晚期肝门胆管癌姑息治疗中的应用价值[J].临床军医杂志,2015,43(3):234-236.
[11]Yuan H,Wu P,Chen J,et al.Radical antegrade modular pancreatosplenectomy for adenocarcinomaof the body of the pancreas in a patient with portal annular pancreas,aberrant hepatic artery,and absence of the celiac trunk:A case report[J].Medicine(Baltimore),2017,96(48):e8738.
[12]Aoba T,Kato T,Hiramatsu K,et al.A case of gastric glomus tumor resection using laparoscopy endoscopy cooperative surgery(LECS)[J].Int J Surg Case Rep,2018,9(42):204-207.
[13]许尔蛟,李凯,郑荣琴,等.三维经胆道超声造影对肝门部胆管癌的诊断价值的初步研究[J].中山大学学报(医学科学版),2015,36(1):150-153.
[14]Li HH,Zhu H,Yue L,et al.Feasibility of free-breathing dynamic contrast-enhanced MRI of gastric cancer using a golden-angle radial stack-of-stars VIBE sequence:comparison with the conventional contrast-enhanced breath-hold 3DVIBE sequence[J].Eur Radiol,2018,28(5):1891-1899.
[15]Han X,Sun MY,Liu JH,et al.Computed tomography imaging features of hepatic perivascular epithelioid cell tumor:A case report and literature review[J].Medicine(Baltimore),2017,96(49):e9046.
[16]牛应林,王拥军,李鹏,等.超声内镜、腹部CT及MRCP对壶腹部病变检出率的比较研究[J].临床和实验医学杂志,2017,16(12):1230-1232.
[17]Furukawa K,Tanizawa Y,Kusafuka K,et al.Amputation neuroma mimicking lymph node metastasis of remnant gastric cancer:a case report[J].Surg Case Rep,2017,3(1):123.
[18]李拓.肝外胆管癌超声造影和增强MRI影像学特征及诊断价值比较[J].中国CT和MRI杂志,2017,15(6):76-79.
[19]Tsurumaru D,Miyasaka M,Muraki T,et al.Histopathologic diversity of gastric cancers:Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type[J].Eur J Radiol,2017,12(97):90-95.
[20]李敏.超声造影对肝脏占位性病变性质判定的临床意义[J].影像研究与医学应用,2017,18(11):158-159.
[21]Ebi M,Sugiyama T,Yamamoto K,et al.A gastric glomus tumor resected using non-exposed endoscopic wall-inversion surgery[J].Clin J Gastroenterol,2017,10(Suppl 2UCTN):1-6.
[22]王彦冬,经翔,丁建民,等.超声三维成像与磁共振胰胆管造影对肝门部胆管癌分型诊断的比较研究[J].中华超声影像学杂志,2016,25(2):140-145.
[23]Iwaki K,Yagi S,Iida T,et al.Case report of extensive isolated spontaneous celiac trunk dissection after liver transplantation[J].Transplant Proc,2017,49(8):1956-1959.
[2]肖来华,尉继伟.胆总管囊肿26例影像诊断及治疗分析[J].肿瘤研究与临床,2015,27(4):270-272.
[3]Wang L,Wang X,Kou H,et al.Comparing single oral contrast-enhanced ultrasonography and double contrast-enhanced ultrasonography in the preoperative Borrmann classification of advanced gastric cancer[J].Oncotarget,2017,9(9):8716-8724.
[4]谢海琴,魏妮娅,陈芸,等.西甲硅油在提高胃超声造影检查中的应用价值[J].临床超声医学杂志,2015,17(10):696-698.
[5]Perlaza P,Ortín J,Pagès M,et al.Should 18F-FDG PET/CT be routinely performed in the clinical staging of locally advanced gastric adenocarcinoma?[J].Clin Nucl Med,2018,43(6):402-410.
[6]Neciu CV,Puia IC,Badea AF,et al.Greyscale and contrast enhanced ultrasonography for characterization of gastric malignant tumors[J].Med Ultrason,2018,1(1):8-13.
[7]邵丽春,周秀丽,郭庆,等.西甲硅油乳剂在胃超声造影观察中的价值[J].中国临床实用医学,2016,7(4):68-69.
[8]Zhang K,Du X,Yu K,et al.Application of novel targeting nanoparticles contrast agent combined with contrast-enhanced computed tomography during screening for earlyphase gastric carcinoma[J].Exp Ther Med,2018,15(1):47-54.
[9]Furuta A,Isoda H,Ohno T,et al.Left gastric vein visualization with hepatopetal flow information in healthy subjects using non-contrast-enhanced magnetic resonance angiography with balanced steady-state free-precession sequence and time-spatial labeling inversion pulse[J].Korean J Radiol,2018,19(1):32-39.
[10]王华,汪涛,汤礼军.介入影像医学技术在晚期肝门胆管癌姑息治疗中的应用价值[J].临床军医杂志,2015,43(3):234-236.
[11]Yuan H,Wu P,Chen J,et al.Radical antegrade modular pancreatosplenectomy for adenocarcinomaof the body of the pancreas in a patient with portal annular pancreas,aberrant hepatic artery,and absence of the celiac trunk:A case report[J].Medicine(Baltimore),2017,96(48):e8738.
[12]Aoba T,Kato T,Hiramatsu K,et al.A case of gastric glomus tumor resection using laparoscopy endoscopy cooperative surgery(LECS)[J].Int J Surg Case Rep,2018,9(42):204-207.
[13]许尔蛟,李凯,郑荣琴,等.三维经胆道超声造影对肝门部胆管癌的诊断价值的初步研究[J].中山大学学报(医学科学版),2015,36(1):150-153.
[14]Li HH,Zhu H,Yue L,et al.Feasibility of free-breathing dynamic contrast-enhanced MRI of gastric cancer using a golden-angle radial stack-of-stars VIBE sequence:comparison with the conventional contrast-enhanced breath-hold 3DVIBE sequence[J].Eur Radiol,2018,28(5):1891-1899.
[15]Han X,Sun MY,Liu JH,et al.Computed tomography imaging features of hepatic perivascular epithelioid cell tumor:A case report and literature review[J].Medicine(Baltimore),2017,96(49):e9046.
[16]牛应林,王拥军,李鹏,等.超声内镜、腹部CT及MRCP对壶腹部病变检出率的比较研究[J].临床和实验医学杂志,2017,16(12):1230-1232.
[17]Furukawa K,Tanizawa Y,Kusafuka K,et al.Amputation neuroma mimicking lymph node metastasis of remnant gastric cancer:a case report[J].Surg Case Rep,2017,3(1):123.
[18]李拓.肝外胆管癌超声造影和增强MRI影像学特征及诊断价值比较[J].中国CT和MRI杂志,2017,15(6):76-79.
[19]Tsurumaru D,Miyasaka M,Muraki T,et al.Histopathologic diversity of gastric cancers:Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type[J].Eur J Radiol,2017,12(97):90-95.
[20]李敏.超声造影对肝脏占位性病变性质判定的临床意义[J].影像研究与医学应用,2017,18(11):158-159.
[21]Ebi M,Sugiyama T,Yamamoto K,et al.A gastric glomus tumor resected using non-exposed endoscopic wall-inversion surgery[J].Clin J Gastroenterol,2017,10(Suppl 2UCTN):1-6.
[22]王彦冬,经翔,丁建民,等.超声三维成像与磁共振胰胆管造影对肝门部胆管癌分型诊断的比较研究[J].中华超声影像学杂志,2016,25(2):140-145.
[23]Iwaki K,Yagi S,Iida T,et al.Case report of extensive isolated spontaneous celiac trunk dissection after liver transplantation[J].Transplant Proc,2017,49(8):1956-1959.