摘要
目的探讨良恶性肝肿瘤的超声造影增强时相及回声变化规律。方法对31例共59个肝肿瘤病灶在超声造影后,观察肿瘤病灶在造影增强后各时相图像特点,对比分析良恶性肝肿瘤造影增强的始增时间、峰值时间及减退时间,并对造影前后及增强CT检测的病灶数目、大小及边界清晰度进行比较分析。结果17个肝细胞肝癌病灶中13个表现为典型“快进快退”,2个表现为“同进快退”,另2个表现为“快进慢退”,后经病理证实为高分化型肝癌。36个转移性肝癌病灶分为少血供转移癌组21个,表现为动脉相呈低回声环形增强,门脉相及延迟相呈低回声;多血管转移癌组15个,表现为动脉相呈完全高回声增强,门脉相及延迟相呈低回声。6个肝血管瘤中5个表现为向心性环形持续缓慢充填,另一例直径9mm的小血管瘤表现为完全快速向心充填。肝血管瘤造影增强的始增时间、峰值时间及减退时间均长于肝细胞肝癌及转移性肝癌(P<0.05)。造影后所测肿块直径大于常规超声和增强CT,所检出肿块数目多于常规超声和增强CT,造影前13个肿块边界显示不清晰,造影后显示清晰。结论超声造影在肝肿瘤的定性诊断中有重要价值。
Objective To investigate the value of real-time gray-scale contrast-enhanced sonographic imaging in the diagnosis of liver neoplasms. Methods A total of 31 patients with 59 unconfirmed liver neoplasms underwent contrast-enhanced uhrasonography. The start time, peak time, decrease time and imaging performance of the liver tumors were recorded. Meanwhile, the number of the lumps, their size and boundary were compared before and after contrast-enhanced ultrasound. The parameters of the measurements were also compared with those by enhanced CT. Results Of the 17 cases of hepatic cell carcinoma （HCC）, 13 presented typically with early artery enhancement and immediate wash-out; 2 presented with simultaneous wash-ln and quick wash-out; another 2 presented with quick wash-in and slow wash-out, and the consequent pathology showed well-differentiated hepatic carcinoma. The 36 cases of metastatic hepatic carcinoma were divided into 2 groups： less blood supply metastatic carcinoma group （21 cases）, which presented with circular enhancement in low echo in arterial phase and low echo in portal and late phases; and more blood Supply metasthtic carcinoma group （15 cases）, which presented with enhancement in totally high echo in arterial phase and low echo in portal and late phases： in the 6 cases of hemangioma, 5 lesions were enhanced centripetally and slowly in portal phase; the rest 1 was small （9 mm in diameier ） and was enhanced totally, quickly and centripetally, Compared with the findings by conventional ultrasound and enhanced CT, the number and diameter of the tumor masses were greater and the mass boundary was more distinct by Contrast-enhanced ultrasound. Conclusions The contrast-enhanced ultrasonography is sensitive and effective in the qualitative diagnosis of liver neoplasms.
出处
《中华医学超声杂志（电子版）》
2006年第1期25-27,共3页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
造影剂
肝肿瘤
Ultrasonography
Contrast agent
Liver neoplasms
