摘要
目的 探讨新型超声造影剂与实时灰阶造影匹配成像技术观察肝肿瘤的灌注过程及回声变化规律 ,探讨其对肝恶性肿瘤的诊断价值。方法 3 5例超声不能完全明确诊断或漏诊的肝占位患者 ,2 6例经手术或穿刺病理确诊 ,9例为造影CT、磁共振等临床资料证实 ,恶性肿瘤占 2 8例。采用第二代新型造影剂SonoVue以及TechnosDU6实时超声造影匹配成像技术。造影剂注射方法分别采用静脉快速团注法和慢注法两种。首先观察了正常肝、肝硬化注射造影剂后各个时相出现的时间及峰值 ,在此基础上观察了肝占位病变的造影剂灌注过程。结果 显示典型的原发性肝癌 2 3例均发生动脉早期强化 ,2 1例 (91% )呈快速消退即“快进快出”型 ,另 2例 <2cm的高分化小肝癌表现为动脉早期强化 ,但消退缓慢。肝转移性肿瘤 5例表现多样 ,呈动脉期或门脉期环状强化或不同程度强化 ,消退可快可慢。肝血管瘤 3例动脉期瘤内无强化 ,门静脉期呈向心性填充增强 ,持续时间长 ,数分钟后消退。对原发性肝癌 2 3例进行了两种不同注射方法的比较 ,发现团注法使肝癌病灶更快达到增强峰值 ,更有利于肝癌特征的显示。本组中 3 1例进行了超声造影前、造影后、增强CT的诊断结果比较 ,肿瘤病灶的显示分别为 76灶、99灶、75灶。 11例恶性肿瘤病灶数目较造影前增?
Objective To investigate the role of new contrast agent and real time gray scale contrast tuned imaging in the evaluation of the perfusion and echogenicity of liver neoplasms and to discuss the diagnostic value.Methods Thirty five patients with unconfirmed liver neoplasms were enrolled in the study.Nine of them were diagnosed clinically,while the other 26 cases with pathological evidence through surgery or needle biopsy.Contrast agent SonoVue,Technos DU6 and CnTI technology were used.The contrast agents were delivered intravenously or through bolus injection.Results Timing of all phases following contrast injection in normal and cirrhotic liver was observed.And then the perfusion processs of liver neoplasms was recorded.Among the 23 cases of typical hepatocellular carcinoma(HCC),21 cases(91%) presented with early artery enhancement and immediate wash out,while the other 2 cases of small(<2 cm) hyper differentiated HCC washed out slowly after early artery enhancement.The enhancement pattern of 5 liver metastasis cases was diverse,including peripheral or various degree enhancement in the arterial or portal phase with slow or fast wash out.The 3 cases of haemoangioma were enhanced centripetally in portal phase and washed out slowly after several minutes without arterial enhancement.For HCC,the lesions could reach the peak of enhancement much faster by bolus injection other than intravenously injection.Thirty one patients underwent conventional ultrasound,contrast ultrasound and contrast CT,and the number of detected lesions was 76,99,75,respectively.Contrast ultrasound found more new lesions mostly 3～10 mm in diameter in 11 patients,and enlarged lesions in 5 patients.Conclusions New contrast specific ultrasound technique is significantly superior to conventional ultrasound in liver neoplasm diagnosis,superior to contrast CT in detecting more lesions especially minute ones,thus greatly improves the value of ultrasound in liver neoplasm diagnosis.
出处
《中华超声影像学杂志》
CSCD
2004年第1期38-42,共5页
Chinese Journal of Ultrasonography
基金
首都医学发展科研基金项目 (ZD1 9990 9)
