摘要
目的探讨宫颈癌血管生成的二维超声造影(2D-CEUS)及三维超声造影(3D-CEUS)表现。方法对21例宫颈癌及20例对照组分别进行2D-CEUS和3D-CEUS检查,观察其血流灌注模式及血管构筑特点,并分析时间-强度曲线(TIC)形态及部分参数。采用免疫组织化学技术检测微血管密度(MVD)。结果 2D-CEUS诊断宫颈癌17例,另2例0期原位癌和2例ⅠA1早期浸润癌未被检出。宫颈癌2D-CEUS表现为增强早期病灶区呈均匀性或不均匀性高增强,早于正常肌层;增强晚期病灶内部先减退,周边部呈稍高增强。宫颈癌TIC形态呈"速升速降"或"速升缓降"型,而正常宫颈呈"缓升缓降"型。宫颈癌组较对照组显影时间(AT)、增强时间(△T)明显缩短,增强强度(EI)及单位时间强度变化(k)明显增高(P均<0.05),达峰时间(TTP)提前,但两组间差异无统计学意义(P>0.05)。3D-CEUS显示18例宫颈癌的病灶区血管数目增多,结构紊乱的征象,另2例0期原位癌和1例ⅠA1早期浸润癌未能显示异常血管。宫颈癌组MVD显著高于对照组(P<0.05)。结论 2D-CEUS和3D-CEUS的联合运用,有利于提升肿瘤微血管生成的可视化及定量研究,为临床准确评估宫颈癌活体肿瘤血管生成提供有效的影像学方法。
Objective To explore angiogenesis of cervical cancer by two-dimensional contrast-enhanced ultrasound （2D-CEUS） and three-dimensional contrast-enhanced ultrasound （3D-CEUS）. Methods Twenty-one cases of cervical carcinoma and 20 cases of control group were studied by 2D-CEUS and 3D- CEUS. The blood perfusion patterns and angiogenesis characteristics were observed. According to the acoustical time-intensity curve （TIC） form, the perfusion quantified parameters and mode of cervical carcinoma were analyzed. The microvessel density （MVD） in both two groups was detected by immunohistochemical techniques. Results In the twenty-one cases, seventeen cases were correctly diagnosed by 2D-CEUS wbile two carcinoma in situ cases and two preinvasive （ I A1 ） cases were not detected. After agent administration, the enhancement of invasive carcinoma homogeneously or heterogeneously was found in the arterial phase, earlier than the normal myometrium with peripheral enhancement in late phase. TIC appeared quick-up and quick-down type or quick-up and slow-down type in the malignant lesions, but slow-up and slow-down type in the myometrium of normal uterus. Compared to the control group, the arrival time （AT） and the enhanced time （△T） of cervical carcinoma group were significantly shorter while the enhanced intensity（EI） and unit time strength changes（k） were increased obviously（ P 〈 0.05 ）. Although the time to peak （TYP） were earli- er, no significant difference between two groups was obcerved. By 3D-CEUS, the majority of disorder was displayed in eighteen cases with carcinoma, but two carcinoma in situ and one preinvasive （ I AI ） were failed to display. The mean MVD of cervical tissue between two groups showed significant difference （P 〈 0.05）. Conclusion Combining 2D-CEUS with 3D-CEUS can obviously improve the degree of virtual tumor angiogensis and quantitive study, which can provide a new and effective imaging method for clinical evaluation of tumor angiogensis in the cervical carcinoma.
出处
《中华医学超声杂志（电子版）》
2010年第7期43-46,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
造影剂
宫颈癌
血管生成
Ultrasonography
Contrast media
Cervical carcinoma
Angiogenesis
