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| 1 | 超声造影联合普美显磁共振对肝硬化背景下微小肝细胞肝癌的诊断研究显示文摘目的比较超声造影(CEUS)和普美显磁共振(EOB-MRI)对肝硬化背景下直径≤2 cm肝细胞肝癌(HCC)的诊断效能,探究CEUS动脉期联合EOB-MRI肝胆期对微小肝癌的诊断价值。方法回顾性分析2016年2-12月于天津市第三中心医院收集的98例肝硬化患者共113个直径≤2 cm的结节在CEUS和EOB-MRI中的增强模式。以病理诊断或随访作为参考标准,分析CEUS和EOB-MRI对直径≤2 cm HCC的诊断效能。以CEUS动脉期联合EOB-MRI肝胆期作为HCC的诊断标准,探究该诊断标准对直径≤2 cm HCC的诊断价值。结果CEUS和EOB-MRI对HCC单独诊断的ROC曲线下面积分别为0.858、0.814(P>0.05),敏感性为79.1%、81.4%,特异性为92.6%、81.5%,准确性为82.3%、81.4%。以CEUS和EOB-MRI同时诊断HCC作为标准,ROC曲线下面积为0.831,与CEUS和EOB-MRI单独诊断相比差异无统计学意义(0.831对0.858,0.814;均P>0.05),对HCC的诊断敏感性为66.3%,特异性为100%,准确性为74.3%。以CEUS动脉期高增强联合EOB-MRI肝胆期低信号作为诊断标准,ROC曲线下面积为0.934,与CEUS和EOB-MRI单独诊断及CEUS和EOB-MRI同时诊断相比差异有统计学意义(0.934对0.858,0.814,0.831;均P<0.05),对HCC的诊断敏感性为94.2%,特异性为92.6%,准确性为93.8%。结论CEUS动脉期联合EOB-MRI肝胆期对肝硬化背景下微小肝癌的诊断具有较高的敏感性和准确性,可作为在CEUS和EOB-MRI表现为不典型增强模式的微小HCC的新的补充增强模式,有助于HCC的诊断。 | 丁建民 周燕 王凤梅 张翔 王彦冬 周洪雨 经翔 | 2019 | 中华超声影像学杂志2019，28，11： | 47 |
| 2 | MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients显示文摘To date the imaging diagnosis of liver lesions is based mainly on the identification of vascular features, which are typical of overt hepatocellular carcinoma(HCC), but the hepatocarcinogenesis is a complex and multistep event during which, a spectrum of nodules develop within the liver parenchyma, including benign small and large regenerative nodule(RN), low-grade dysplastic nodule(LGDN), high-grade dysplastic nodule(HGDN), early HCC, and well differentiated HCC. These nodules may be characterised not only on the basis of their respective different blood supplies, but also on their different hepatocyte function. Recently, in liver imaging the introduction of hepatobiliary magnetic resonance imaging contrast agent offered the clinicians the possibility to obtain, at once, information not only related to the vascular changes of liver nodules but also information on hepatocyte function. For this reasons this new approach becomes the most relevant diagnostic clue for differentiating low-risk nodules(LGDN-RN) from highrisk nodules(HGDN/early HCC or overt HCC) and consequently new diagnostic algorithms for HCC have been proposed. The use of hepatobiliary contrast agents is constantly increasing and gradually changing the standard of diagnosis of HCC. The main purpose of this review is to underline the added value of Gd-EOB-DTPA in early-stage diagnoses of HCC. We also analyse the guidelines for the diagnosis and management of HCC, the key concepts of HCC development, growth and spread and the imaging appearance of precursor nodules that eventually may transform into overt HCC. | Riccardo Inchingolo Riccardo Faletti Luigi Grazioli Eleonora Tricarico Marco Gatti Anna Pecorelli Davide Ippolito | 2018 | World Journal of Hepatology2018，10，7： | 37 |
| 3 | 肝细胞癌肝动脉门静脉分流形成的相关因素分析显示文摘目的总结肝细胞癌(HCC)合并肝动脉门静脉分流(APS)、肝动脉肝静脉分流(AVS)的发生率,并探讨影响HCC APS形成的相关因素。方法回顾分析2009年1月-2010年12月经动脉栓塞(TAE)治疗的.497例HCC患者的影像学和病历资料,总结APS、AVS的发生率,采用单因素分析APS的发生与HCC患者性别、年龄、乙型肝炎病史、肝硬化基础、肝癌切除史、甲胎蛋白(AFP)、肿瘤类型、肿瘤数目和门静脉癌栓(PVTT)的相关性,并行多因素Logistic回归分析。结果HCC合并APS的发生率为10.5%(52/497),合并AVS的发生率为1.6%(8/497),同时合并APS与AVS的有3例(0.6%)。单因素分析显示:乙型肝炎病史、肝硬化基础、肿瘤类型、肿瘤数目和门静脉癌栓与HCC患者APS的发生相关;多因素Logistic回归分析显示:肝硬化基础、巨块型肿瘤、肿瘤多发、门静脉癌栓是HCC合并APS发生的危险因素。结论HCC患者有肝硬化基础、巨块型肿块、多发肿瘤。 | 孙磊 施海彬 刘圣 杨正强 周春高 冯耀良 王杰 夏金国 赵林波 周卫忠 李麟荪 | 2012 | 介入放射学杂志2012，21，3： | 28 |
| 4 | Improving recognition of hepatic perivascular epithelioid cell tumor:Case report and literature review显示文摘A 58-year-old man presented with the chief complaint of abdominal bloating and was incidentally found to have a liver tumor.As diagnostic imaging studies could not rule out malignancy,the patient underwent partial resection of segment 3 of the liver.The lesion pathologically showed eosinophilic proliferation,in addition to immunohistochemical positivity for human melanoma black 45 and Melan-A,thereby leading to the diagnosis of a hepatic perivascular epithelioid cell tumor(PEComa).A PEComa arising from the liver is relatively rare.Moreover,the name ‘PEComa' has not yet been widely recognized,and the same disease entity has been called epithelioid angiomyolipoma(EAML),further diminishing the recognition of PEComa.In addition,PEComa imaging findings mimic those of malignant liver tumors,and clinically,this tumor tends to enlarge.Therefore,a PEComa is difficult to diagnose.We conducted a systematic review of PEComa and EAML cases and discuss the results,including findings useful for differentiating perivascular epithelioid cell tumors from malignant liver tumors. | Toshiya Maebayashi Katsumi Abe Takuya Aizawa Masakuni Sakaguchi Naoya Ishibashi Osamu Abe Tadatoshi Takayama Hisashi Nakayama Shunichi Matsuoka Kazushige Nirei Hitomi Nakamura Masahiro Ogawa Masahiko Sugitani | 2015 | World Journal of Gastroenterology2015，21，17： | 20 |
| 5 | 肝硬化相关结节的MRI研究与进展显示文摘肝硬化结节癌变经历再生结节、低级别不典型增生结节、高级别不典型增生结节到小肝癌,是一个多步骤的过程,其演变过程中重要的特征是血流动力学的改变。早期诊断和鉴别这些不同性质的肝硬化结节非常重要,MRI作为无创性的影像学方法,在肝硬化相关结节的诊断中起着重要作用,就肝硬化相关结节的MRI的研究进展予以综述。 | 王梅 张龙江 卢光明 | 2012 | 国际医学放射学杂志2012，35，5： | 19 |
| 6 | Gd-EOB-DTPA增强MRI评价肝细胞肝癌分化程度显示文摘目的:基于钆塞酸二钠(Gd-EOB-DTPA)增强MRI探讨肝细胞肝癌的影像表现与分化程度的相关性。方法:回顾性分析61例经本院手术病理证实并行磁共振Gd-EOB-DTPA增强扫描的肝细胞肝癌患者的病例资料。根据肿瘤的分化程度,将患者分为高分化组(21例)、中分化组(26例)和低分化组(14例)。根据肝癌的三期增强扫描表现,将其强化方式分为3型:Ⅰ型为动脉供血型,Ⅱ型为动-静脉供血型,Ⅲ类为乏血供型。计算肿瘤的相对信号强度、强化率和相对强化率。对病变的强化表现与分化程度之间的相关性进行统计学分析。结果:高分化组中Ⅰ型强化10例,Ⅱ型7例,Ⅲ型4例;中分化组中Ⅰ型强化15例,Ⅱ型9例,Ⅲ型2例;低分化组中Ⅰ型强化11例,Ⅱ型3例,无Ⅲ型强化。在肝胆特异期,8例高分化病灶可见对比剂摄取,而低分化组中均无对比剂摄取。随着分化程度的增高,病灶的强化率和相对强化率均逐渐增高(P<0.05)。结论:肝Gd-EOB-DTPA增强MRI对诊断肝细胞肝癌及其分化程度有重要价值。 | 陈佳 文利 龚明福 杨柳 | 2018 | 放射学实践2018，33，12： | 17 |
| 7 | 肝脏转移瘤血供的影像及病理研究显示文摘由于其特殊的解剖结构和双重血供,使肝脏成为了最常见的转移器官之一。许多学者对肝脏转移瘤的血供来源持不同的观点。本文综述了肝脏转移瘤血供的影像及病理研究方法,提出了研究方法的优缺点。 | 吴勇超 李智岗 | 2012 | 介入放射学杂志2012，21，6： | 12 |
| 8 | 肝细胞癌微创与多学科综合诊疗——2018广州共识显示文摘中国绝大多数肝癌是乙型病毒性肝炎和肝硬化长期发展的结果,具有富血供、多中心起源特点,早期即可侵犯门静脉小分支并发生肝内转移。因此,肝癌发生之初即是一种局部器官和全身性疾病。为此,临床上需要采用包括局部治疗[手术切除、射频消融(RFA)、微波消融(MWA)、化学消融、冷冻消融等]、器官水平治疗[经导管动脉灌注化疗(TAIC)、TACE]和系统治疗(免疫治疗、抗病毒治疗、分子靶向治疗)在内的综合治疗方案。本共识阐述肝细胞癌微创与多学科综合诊断和治疗方法,凸显八大亮点:①肝动脉造影、肝动脉造影 CT(CTHA)、动脉-门静脉造影 CT(CTAP)、碘化油 CT(Lp-CT)、TACE-CT 有助于发现子灶,精确分期;②TACE/消融作为早期肝癌首选治疗;③浸润型肝癌作为独立分型;④微创综合治疗转移淋巴结;⑤M(转移)分期细化用于指导个体化治疗和判断预后;⑥肝癌伴肝功能严重失代偿是肝移植候选标准;⑦提倡生物免疫、中医中药、抗病毒及社会心理治疗贯穿各期治疗方案;⑧建议开展早、中期肝癌微创介入治疗与外科手术多中心随机对照试验研究。 | 无 吴沛宏 李旺 陈奇峰 | 2019 | 介入放射学杂志2019，28，7： | 11 |
| 9 | Gadoxetic acid-enhanced magnetic resonance imaging can predict the pathologic stage of solitary hepatocellular carcinoma显示文摘BACKGROUND Although important for determining long-term outcome, pathologic stage of hepatocellular carcinoma (HCC) is difficult to predict before surgery. Current state-of-the-art magnetic resonance imaging (MRI) using gadoxetic acid provides many imaging features that could potentially be used to classify single HCC as pT1 or pT2. AIM To determine which gadoxetic acid-enhanced MRI (EOB-MRI) findings predict pathologic stage T2 in patients with solitary HCC (cT1). METHODS Pre-operative EOB-MRI findings were reviewed in a retrospective cohort of patients with solitary HCC. The following imaging features were examined: Hyperintensity in unenhanced T2-weighted images, hypointensity in unenhanced T1-weighted images, arterial enhancement, corona enhancement, washout appearance, capsular appearance, hypointensity in the tumor tissue during the hepatobiliary (HB) phase, peritumoral hypointensity in the HB phase, hypointense rim in the HB phase, intratumoral fat, hyperintensity on diffusionweighted imaging, hypointensity on apparent diffusion coefficient map, mosaic appearance, nodule-in-nodule appearance, and the margin (smooth or irregular). Surgical pathology was used as the reference method for tumor staging. Univariate and multivariate analyses were performed to identify predictors of microvascular invasion or satellite nodules. RESULTS There were 39 (34.2%;39 of 114) and 75 (65.8%;75 of 114) pathological stage T2 and T1 HCCs, respectively. Large tumor size (≥ 2.3 cm) and two MRI findings, i.e., corona enhancement [odds ratio = 2.67;95% confidence interval: 1.101-6.480] and peritumoral hypointensity in HB phase images (odds ratio = 2.203;95% confidence interval: 0.961-5.049) were associated with high risk of pT2 HCC. The positive likelihood ratio was 6.25 (95% confidence interval: 1.788-21.845), and sensitivity of EOB-MRI for detecting pT2 HCC was 86.2% when two or three of these MRI features were present. Small tumor size and hypointense rim in the HB phase were regarded as benign features. Small HCCs with hypointense rim but not associated with aggressive features were mostly pT1 lesions (specificity, 100%). CONCLUSION Imaging features on EOB-MRI could potentially be used to predict the pathologic stage of solitary HCC (cT1) as pT1 or pT2. | Yi-Chen Chou I-Ha Lao Pei-Ling Hsieh Ying-Ying Su Chee-Wai Mak Ding-Ping Sun Ming-Jen Sheu Hsing-Tao Kuo Tzu-Ju Chen Chung-Han Ho Yu-Ting Kuo | 2019 | World Journal of Gastroenterology2019，25，21： | 10 |
| 10 | 高帧频超声造影在肝富血供占位性病变动脉期中的成像优势与临床价值显示文摘目的探讨高帧频超声造影(H-CEUS)在肝富血供结节动脉期成像的优势及其潜在的临床价值。方法选取2018年5月至2019年12月在解放军总医院第一医学中心因肝局灶性病变而行超声造影(CEUS)检查患者88例。根据病理及增强磁共振结果分为恶性组和良性组。研究对象分别行超声、CEUS和H-CEUS检查并记录动态图像。2位医师分别对超声、CEUS和H-CEUS图像进行独立分析并记录结果,统计分析CEUS和H-CEUS图像特征。采用t检验比较良性组和恶性组患者年龄和结节最大径的差异,采用χ^2检验比较良性组和恶性组患者性别、结节数量和结节血流的差异、2种超声造影模式特征(开始增强时间、增强程度、均匀性、方向和血管形态)的差异以及2种造影模式下不同大小恶性结节血管形态的差异。结果良性组与恶性组间患者年龄(t=3.428,P=0.001)、结节最大径(t=3.039,P=0.003)及结节血流比较(χ^2=8.159,P=0.004)差异均有统计学意义。开始增强时间、增强程度与均匀性在CEUS和H-CEUS技术间比较,差异均无统计学意义(P均> 0.05)。造影增强方向及血管形态在2种造影技术间比较,差异均有统计学意义(χ^2=54.795、11.510,P均<0.05)。结节最大径≤3.0 cm的恶性组中2种造影技术在显示血管形态方面,差异有统计学意义(χ^2=12.983,P <0.001),结节最大径> 3.0 cm的恶性组中2种造影技术在显示血管形态方面,差异无统计学意义(P> 0.05)。结论通过提高超声图像帧频有助于准确地显示动脉期的增强特征和血管形态,尤其是对于最大直径≤3.0 cm的富血供结节H-CEUS可以弥补CEUS在这方面的局限性。 | 费翔 罗渝昆 李楠 韩鹏 唐文博 李杰 | 2020 | 中华医学超声杂志(电子版)2020，17，9： | 10 |
| 11 | Efficacy of Early Treatment on 52 Patients with Preneoplastic Hepatitis B Virus-Associated Hepatocellular Carcinoma by Compound Phyllanthus Urinaria L.显示文摘Objective:To observe the change in the number of antibodies of preneoplastic hepatocellular carcinoma(HCC) using early treatment by Compound Phyllanthus Urinaria L.(CPUL) on patients with preneoplastic hepatitis B virus(HBV)-associated HCC.Methods:A total of 102 cirrhosis patients with regenerative or dysplastic nodules whose sera were tested positive for at least one of these six proteins(five up-regulated genes URG4,URG7,URG11,URG12 and URG19,and one down-regulated gene DRG2) were assigned randomly to two groups using continual random codes by SPSS software.Fifty-two patients were in the treatment group and 50 patients were in the control group.CPUL was used in the treatment group for 3 years,while the control group did not receive any treatment.The changes in HBV-DNA level,number of antibodies,and hepatocarcinogenesis occurred were observed.Patients who did not develop HCC were followed up for another 2 years.Results:HBV-DNA levels decreased >2log in 22.2%(10/45) of patients in the treatment group in contrast to only 5.0%(2/40) of patients in the control group(P=0.0228).The number of antibodies that were tested positive in the treatment group(1.08± 1.01)was significantly lower compared with the control group(2.11 ±1.12) after 24 months of drug treatment(P<0.01).Both the positive rates of anti-URG11(33/52) and anti-URG19(31/52) were over 60%at baseline in the two groups,and were decreased to 48.1%(25/52) and 46.2%(24/52) respectively at 36 months of drug treatment,while the rates increased to 68.0%(34/50) and 66.0%(33/50) respectively(P=0.0417,P=0.0436) in the control group.The positive rate of anti-DRG2 was increased to 55.8%(29/52) at 36 months of drug treatment,while in the control group was decreased to 36.0%(18/50,P=0.0452).Among the 102 patients who developed HCC,2 were in the treatment group and 9 were in the control group,meaning that a significant difference between the two groups(P=0.0212).In11 patients who developed HCC,anti-URG11 and anti-URG19 were always positive,while anti-DRG2 was negative.Patients newly developing HCC were 6(20.0%) in the control group,and only one(2.5%) in the treatment group(P=0.0441) during 2-year follow-up after the end of the treatment.Conclusions:Anti-URG11,anti-URG19 and antiDRG2 could be used as early markers in the prediction of the therapeutic efficacy of CPUL in treating preneoplastic HCC.CPUL is useful in preventing or delaying the development of HBV-associated cirrhosis to HCC. | 童光东 张希 周大桥 魏春山 贺劲松 肖春玲 刘心亮 郑颖俊 陈思暖 唐海鸿 | 2014 | Chinese Journal of Integrative Medicine2014，20，4： | 9 |
| 12 | 超声造影定量分析评估门静脉癌栓对肝癌血流动力学的影响显示文摘【目的】探讨超声造影(CEUS)定量分析在门静脉癌栓(PVTT)对原发性肝癌(HCC)血流动力学影响中的价值。【方法】回顾性分析7例HCC合并PVTT和14例HCC未合并PVTT患者的超声造影动态图像,以SonoLiverTM定量软件进行分析,获得肝癌与周围肝实质的时间-强度曲线,最大峰值强度(IMAX)、上升时间(RT)、平均渡越时间(MTT)、达峰时间(TTP)分别于组内及组间进行比较。【结果】①组内比较:PVTT组和对照组中HCC的RT和TTP均快于周围肝实质。对照组HCC的IMAX显著高于周围肝较强,而PVTT组中,HCC的IMAX与周围肝实质无显著性差异。②组间比较:PVTT组的RT和TTP无论HCC还是肝实质,均快于对照组。而在PVTT组HCC的IMAX较对照组显著降低。【结论】HCC合并PVTT后与对照组有着不同的血流动力学参数,其RT和TTP增快、IMAX减低,这可能为微小癌栓的预测提供一定的临床价值。 | 王竹 刘广健 吕明德 谢晓燕 王伟 徐作峰 林满霞 黄漾 | 2014 | 中山大学学报(医学科学版)2014，35，3： | 9 |
| 13 | 肝硬化结节多步癌演变的Gd^+-EOB-DTPA的磁共振表现显示文摘MRI检查技术的不断发展,肝小病灶(≤2.0cm)的检出率明显提高,尤其是乙肝、丙肝慢性肝炎以及肝硬化等患者,影像学定期随访特别是MRI可明显提高早期肝细胞癌(early hepatocellular carcinoma,eHCC)或小肝细胞癌(small hepatocellular carcinoma,sHcc)的检出率和诊断符合率,因此,MRI对提高肝细胞癌治疗有效率和生存率等具有十分重要的作用[1]。 | 丁莺 饶圣祥 陈财忠 曾蒙苏 | 2013 | 放射学实践2013，28，5： | 8 |
| 14 | 肝癌血流动力学改变及其意义显示文摘正常肝脏的血流量为800~1 200 ml/min,肝脏接受血量约为心输出量的25%,其中门静脉供血约占75%,肝动脉约占25%。肝脏所需氧量动脉供给占50%以上,但肝脏会根据需要进行相应调整。原发性肝癌(肝癌)往往会引起肝脏双重供血及肝静脉回流异常,导致肝脏血流动力学改变,包括肝动脉和门静脉局部血管重构及其血流流场变化[1]。肝脏血流动力学改变对肿瘤的发展和恶化又会起到重要的影响作用。二者相互作用影响肝癌的发生、发展、复发、转移等。本文对肝癌血供改变及其对临床诊治预后意义进行初步阐述。 | 许戈良 | 2018 | 中华肝脏外科手术学电子杂志2018，7，2： | 7 |
| 15 | 肝细胞癌的影像学研究现状与进展显示文摘影像学检查是肝细胞癌(Hepatocelluar Carcinoma,HCC)诊断与监测的重要手段。多种影像学征象与HCC的组织病理、生物学行为相关,并据此可以指导治疗方案、早期评判疗效和预测预后。近年来采用功能与代谢磁共振成像技术,如动态增强磁共振成像、弥散加权成像、肝脏特异性MRI对比剂、血氧水平依赖成像、动脉自旋质子标记、磁敏感成像、波谱成像等,已成为HCC的影像研究热点。本文就近年来肝细胞癌的影像学研究现状与进展作一述评。 | 宋彬 吴苾 | 2015 | 西部医学2015，27，4： | 7 |
| 16 | 双能量CT碘图强化值与肝细胞癌血管生成的相关性研究显示文摘目的 探讨双源CT碘图强化值与肝细胞癌形成过程不同阶段结节血管生成的相关性.方法 选择本院2010-08-2012-06临床拟诊为肝细胞癌而需行肝移植术的受体26例纳入研究.术前行双源CT扫描,测量肝硬化相关结节的动脉期碘图强化值;术后测量其血管内皮生长因子(VEGF)免疫反应积分值及微血管密度(MVD).分析不同病理类型结节动脉期双能量碘图强化值与病理定量指标的关系.结果 将所得44个结节按照病理性质分为3组:再生结节(regenerative nodule,RN) 11个,不典型增生结节(dysplastic nodule,DN)10个,肝细胞癌(hepatocellular carcinoma,HCC) 23个.①3组动脉期碘图强化值的差异有统计学意义(F=4.031,P<0.001),HCC组碘图强化值分别与RN及DN组差异有统计学意义(P<0.05),而RN组及DN组之间差异无统计学意义(P>0.05).②MVD与动脉期碘图强化值呈正相关(r=0.545,P<0.001).③VEGF免疫反应积分与动脉期碘图强化值呈正相关(r=0.405,P<0.05).结论 双源CT动脉期双能量碘图强化值与MVD和VEGF免疫反应积分之间具有正相关性,能够定量反映肝细胞癌形成中的血管生成状态. | 张晓东 季倩 程悦 黄黎香 范文骏 沈文 | 2014 | 实用放射学杂志2014，30，2： | 6 |
| 17 | 肝癌的影像学诊断进展显示文摘原发性肝癌是全球性的健康问题,每年超过70万人诊断为肝癌[1]。我国是原发性肝癌的高发国家,每年至少发现10万例新患者,并有20-30万例患者死亡[2],发病率及死亡率均居世界之首。我国的肝癌患者大多数是在乙型肝炎、肝硬化基础上发展而来的,对于发现早的小肝癌(〈3 cm)患者,无论采取何种治疗,均能明显提高患者5年生存率,降低复发率[3]。影像学是肝癌检查的主要方法,本文主要就 CT 和 MRI在肝癌诊断中的应用作一综述。 | 王光宪 文利 | 2014 | 实用放射学杂志2014，30，6： | 6 |
| 18 | 肝癌病理与肝癌血供的相关性研究显示文摘目的探讨肝癌的病理特点及其与肝癌血供的相关关系,为临床治疗提供参考。方法回顾性分析34例肝癌患者的病理学特征,并将病理学分型与影像学资料相对照。结果 34例病灶,组织学类型为梁状型21例,占总数的61.8%,多为肝动脉供血型;其次为6例实体型,均为肝动脉供血型;假腺管型5例,血供类型分布较为分散,其中门静脉供血型和少血供型各2例,肝动脉供血型1例;纤维硬化型2例均为少血供型。肝癌不同病理组织学类型的血供类型有关联性(x2=11.140,P=0.004<0.05)。结论肝癌病理分型为梁状型及实体型的常以肝动脉供血为主,假腺管型及纤维硬化型血供较为复杂,除肝动脉供血外,亦可见其他供血类型。 | 石菡 | 2012 | 中国医药科学2012，2，22： | 5 |
| 19 | 超声造影廓清速度评估富血供肝细胞癌分化程度的价值显示文摘目的探讨超声造影(CEUS)廓清速度评估富血供肝细胞癌(HCC)分化程度的价值。方法收集2009年4月至2014年12月四川省南充市中心医院收治的经手术后病理确诊的富血供HCC患者271例,术前2~3 d行CEUS检查。对HCC的CEUS廓清速度进行分级。采用Kruskal-Wallis秩和检验比较不同分化程度HCC的CEUS廓清速度差异;采用Spearman相关分析分析HCC分化程度与CEUS廓清速度的相关性;绘制CEUS廓清速度判断HCC分化程度的操作者工作特征(ROC)曲线。结果本组271个HCC中,18个为高分化,150个为中分化,103个为低分化或未分化。其中19个(7.0%)为CEUS廓清速度1级,65个(24.0%)为CEUS廓清速度2级,157个(57.9%)为CEUS廓清速度3级,30个(11.1%)为CEUS廓清速度4级。不同分化程度HCC的CEUS廓清速度差异有统计学意义(χ~2=179.8238,P<0.001),进一步组间两两比较结果显示,高分化与中分化、高分化与低分化、中分化与低分化HCC的CEUS廓清速度差异均有统计学意义(χ~2=91.23、95.16、29.59,P均<0.01)。CEUS廓清速度越快的HCC分化程度越低,CEUS廓清速度越慢的HCC分化程度越高。ROC曲线显示,廓清速度1级是CEUS廓清速度区分高分化和中低分化HCC的阈值,CEUS廓清速度1级诊断高分化HCC的敏感度和特异度分别为98.0%和77.8%,阳性预测值和阴性预测值分别为96.0%和48.8%,阳性似然比和阴性似然比分别为1.9和0.01。廓清速度4级是CEUS廓清速度区分低分化与高中分化HCC的阈值,CEUS廓清速度4级诊断低分化HCC的敏感度和特异度分别为24.3%和97.0%,阳性预测值和阴性预测值分别为65.3%和61.3%,阳性似然比和阴性似然比分别为3.2和0.7。结论 CEUS廓清速度可在一定程度上反映HCC分化程度。CEUS廓清速度能有效判断高分化HCC,但对中低分化HCC难以有效判断。 | 覃夏川 周翔 刘学彬 马果丰 杨姣 | 2017 | 中华医学超声杂志(电子版)2017，14，3： | 4 |
| 20 | 中国肝细胞癌的微创与多学科综合诊疗策略显示文摘肝细胞癌(HCC)是我国常见的恶性肿瘤之一,在城市中居第2位,农村占第1位,男性多于女性,病死率仅次于肺癌[1-2].近年来,随着HCC影像引导下微创介入治疗技术的不断进步和相关大规模临床随机试验开展,微创介入治疗的地位得到彰显.同时,HCC的多学科综合治疗模式也得到临床广泛认可.本文结合我国肝细胞癌临床特点及诊疗现状,旨在体现肝细胞癌的个体化、理性化、科学化的建设性模式治疗模式,更加全面、综合、具体. | 董安楠 李旺 董军 黎升 沈露俊 张振峰 赵明 王悦 吴沛宏 | 2015 | 中华医学杂志2015，95，21： | 4 |
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