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目的对比观察肝癌的超声与临床病理特征。探讨超声检查在肝癌诊断与病程判断中的应用效果。方法自1988年至1996年经手术治疗原发性肝癌304例。经 B 超检查65例,彩色超声多普勒检查239例,其中超声引导下行穿刺活检18例。结果经超声检查拟诊为肝癌者263例,诊断符合率为86.5%。42例诊断不符合者包括误诊9例,仅提示可疑病灶30例.未发现病灶3例。可疑病灶经穿刺活检诊断率为94.4%(17/18)。无论原发癌灶大小.超声对卫星灶、脉管癌栓、淋巴结转移三者总的检出率仅分别为48.1%(51/106)、40.5%(32/79)、36.8%(14/38)。结论对没有典型超声图像特征而 AFP 为阴性的病灶,可选择穿刺活检以防误诊或漏诊。超声对肝癌病程发展的判断与手术后临床存有诊断差距。临床医生应结合 CT、MRI 或 DSA 检查推断实际病程。
Objective To compare the ultrasonographic and clinicopathological features of liver cancer. To explore the application effect of ultrasonography in the diagnosis and course of liver cancer. Methods 304 cases of primary liver cancer were treated surgically from 1988 to 1996. After B-ultrasound in 65 cases, color Doppler ultrasound examination of 239 cases, including ultrasound-guided needle biopsy in 18 cases. Results 263 cases of liver cancer were diagnosed by ultrasonography. The diagnostic accuracy rate was 86.5%. Among the 42 cases with misdiagnosis, 9 cases were misdiagnosed, and only 30 cases were suspected suspicious lesions. No lesions were found in 3 cases. The diagnostic rate of suspicious lesions by biopsy was 94.4% (17/18). Regardless of the size of the primary tumor, the total detection rates of ultrasound, tumor thrombosis, and lymph node metastasis were 48.1% (51/106), 40.5% (32/79), and 36.8% (14/) respectively. 38). Conclusions For lesions with non-typical ultrasound features and AFP-negative lesions, biopsy can be selected to prevent misdiagnosis or missed diagnosis. Ultrasound has a diagnostic gap between the judgment of the progression of liver cancer and the postoperative clinical presence. The clinician should extrapolate the actual course of disease with CT, MRI, or DSA.