Abstract:

Objective To explore the contrast-enhanced mode and diagnostic value of contrast-enhanced ultrasonography in recurrent lesions of hepatocellular carcinoma after liver transplantation. Methods A totalnumber of 124 liver transplant recipients with pathological confirmed liver cancer recurrence in the OrganTransplantation Department of the Third Medical Center of PLA General Hospital from October 2007 to January 2022were selected as the objects of study.Thecontrast-enhanced mode and contrast-enhanced ultrasound diagnosis ofrecurrent liver cancer were analyzed and compared with pathology. Four tables were used to calculate the sensitivity，specificity，positive predictive value，negative predictive value and accuracy of contrast-enhanced ultrasound inthe diagnosis of liver cancer recurrence after liver transplantation. Linear weighted Kappa test was usedto analyzethe consistency between contrast-enhanced ultrasound and pathological diagnosis.Results Atotal number of124 cases of liver tumor recurrence 

were diagnosed pathologically，including 59 cases of single lesion and 65 cases of multiple foci. Contrast-enhanced ultrasound mode: arterial phase high enhancement in 96 cases，equal enhancement in 16 cases，low enhancement in 12 cases，fast in and fast out in 106 cases，fast in and slow out in 5 cases，equal in and slowout in 11 cases，equal in and slow out in 2 cases. The sensitivity，specificity，positive predictive value，negative predictivevalue and accuracy of contrast-enhanced ultrasound in the diagnosis of recurrence were 97.6%，97.4%，98.4%，96.2% and 97.5%，respectively. The results of contrast-enhanced ultrasound and pathological diagnosis were consistent，and theKappa value was 0.948（P ＜ 0.001）. Conclusion The results of contrast-enhanced ultrasonography are consistentwith pathological diagnosis. According to its characteristic enhancement mode，

contrast-enhanced ultrasound has important clinical value in the diagnosis ofrecurrent liver tumor afterliver transplantation. 

Key words:

Primary liver cancer, Contrast-enhanced ultrasound, Liver transplantation, Recurrenceof liver cancer

摘要：

目的 探讨肝癌肝移植术后移植肝复发病灶的超声造影增强模式及诊断价值。方法 回顾性分析解放军总医院第三医学中心器官移植科 2007 年 10 月至 2022 年 1 月，术前临床诊断原发性肝癌行肝移植术后肝癌复发并经病理证实的 124 例患者病例资料，分析复发灶超声造影增强模式及诊断肝癌复发的灵敏度、特异度、阳性预测值、阴性预测值、准确性，并采用线性加权 Kappa 检验对超声造影诊断结果与病理诊断结果进行一致性分析。结果 病理诊断移植肝脏肿瘤复发 124 例，其中单发病灶 59 例，多发病灶 65 例。超声造影模式 ：动脉期高增强 96 例，等增强型 16 例，低增强 12 例，快进快出 106 例，快进慢出 5 例，等进快出 11 例，等进慢出 2 例。超声造影诊断移植肝肝癌复发的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别为 97.6%、97.4%、98.4%、96.2%、97.5%。对超声造影诊断结果与病理诊断结果进行一致性分析，Kappa 值为 0.948（P ＜ 0.001）。 结论 超声造影诊断结果与病理诊断一致性较好，超声造影根据其特征性增强模式，对肝癌肝移植后移植肝复发病灶的明确诊断具有重要临床价值。

关键词:

原发性肝癌 , 超声造影 , 肝移植 , 肝癌复发