摘要
目的探讨超声造影对肝脏局灶性病变的定量分析结果及临床价值。方法选取2017年1月~2019年1月100例肝脏病变患者,根据病变性质分为恶性组(n=67)和良性组(n=33)。分别进行实时超声造影及彩色多普勒超声检查。应用时间-强度曲线(TIC曲线)分析超声造影图像。结合TIC曲线形态及由TIC曲线得到的病灶的始增时间、达峰时间、峰值强度、峰值减半时间,分析良恶性病灶造影灌注特点。分析肝癌病灶超声造影类型与彩色多普勒超声血流分级的肿瘤大小关系。结果恶性组TIC的始增时间、达峰时间、峰值减半时间均明显早于良性组,峰值强度明显强于良性组,差异均有统计学意义(P<0.01)。随着血流分级的升高,超声造影类型的环绕型、网络型比率有降低趋势,混合型、树枝型的比率有升高趋势。血流分级与超声造影类型间存在明显相关性(χ^(2)=21.647,P=0.010)。肿瘤≤3 cm的病灶超声造影类型以环绕型和网络型为主。肿瘤> 3 cm的病灶超声造影类型以混合型和树枝型为主。肿瘤大小与超声造影类型有明显相关性(Z=-3.768,P=0.000)。肿瘤分化程度与超声造影类型间存在明显相关性(χ^(2)=35.950,P=0.000)。结论实时超声造影能显示肝脏局灶性病变内部血流灌注情况、判断肿瘤大小及分化程度,根据造影增强方式和TIC曲线参数能够有效鉴别肝脏良恶性病灶。
Objective To evaluate the clinical value and quantitative analysis results of contrast-enhanced ultrasound on focal liver lesions. Methods From January 2017 to January 2019, 100 patients with liver lesions were divided into malignant group(n=67) and benign group(n=33) according to the nature of the lesions. Real-time contrast-enhanced ultrasound and color doppler examination were performed respectively. Contrast-enhanced ultrasound images were analyzed by time-intensity curve(TIC). Combining the TIC curve morphology, onset time, peaking time, peak intensity and peak halving time, the characteristics of angiographic perfusion of benign and malignant lesions were analyzed. We analyzed the relationship between the types of contrast-enhanced ultrasonography and color Doppler flow grading and tumor size in liver cancer. Results The onset time, peaking time and peak halve time of TIC in the malignant group were significantly earlier than those in the benign group, and the peak intensity was significantly stronger than that in the benign group, with statistically significant differences(P<0.01). With the increase of blood flow grade, the ratio of surround type and network type of CEUS type tended to decrease, while, the ratio of mixed type and branch type tended to increase. There was a significant correlation between blood flow grading and CEUS type(χ^(2)=21.647, P=0.010). The CEUS types of lesions with tumor size less than or equal to 3 cm were dominated by surround type and network type. CEUS of the tumor size > 3 cm was mainly mixed type and branch type. There was a significant correlation between tumor size and CEUS type(Z=-3.768, P=0.000). The degree of tumor differentiation was significantly correlated with CEUS type(χ^(2)=35.950, P=0.000). Conclusion Real-time contrast-enhanced ultrasonography can display the internal blood perfusion in focal lesions of the liver, judge the size and differentiation degree of the tumor, and effectively identify benign and malignant liver lesions according to the contrast-enhanced mode and TIC curve parameters.
作者
张渊
邓舒昊
朱一成
施秀荣
单君
江泉
ZHANG Yuan;DENG Shuhao;ZHU Yicheng;SHI Xiurong;SHAN Jun;JIANG Quan(Department of Ultrasonic,Pudong New Area Peoples’Hospital Affiliated to Shanghai Health University,Shanghai 201200,P.R.China)
出处
《医学影像学杂志》
2021年第2期259-263,共5页
Journal of Medical Imaging
基金
上海市浦东新区科技发展基金项目(编号:PKJ2018-Y11)
上海市浦东新区卫生和计划生育委员会学科带头人培养项目(编号:PWRd2017-06)。
关键词
肝脏恶性肿瘤
超声造影
时间-强度曲线
Liver malignant tumor
Contrast-enhanced ultrasonography
Time-intensity curves
