| 荣雪余,冀鸿涛,朱强,肖萍,王振常.超声造影在肝局灶性病变鉴别诊断中的应用[J].中国医学影像技术,2008,24(3):402~405 |
| 超声造影在肝局灶性病变鉴别诊断中的应用 |
| The application of contrast-enhanced ultrasonography in differential diagnosis of focal liver lesions |
| 投稿时间：2007-10-09 修订日期：2007-11-09 |
| DOI： |
| 中文关键词: 超声检查,介入性 肝脏疾病 诊断 |
| 英文关键词:Ultrasonography, interventional Liver diseases Diagnosis |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨超声造影(CEUS)在肝脏局灶性病变(FLL)鉴别诊断的作用。方法 应用超声造影剂(SonoVue)和脉冲反相谐波技术(PIHI),分析观察39例52灶FLL(包括良性28灶,恶性24灶)的CEUS动态灌注过程,分析病灶主要增强时相、开始增强时间、增强峰值时间、增强模式及时间-强度曲线(TIC)。计算各参数、综合CEUS及普通超声在良、恶性FLL鉴别诊断中的符合率。 结果 在CEUS动脉期,良恶性病灶均以高增强为主(75％、21/28;92.6％、22/24)(P＝0.113);在门脉期和延迟期,良性病灶均以高增强为主(75％、21/28;60.7％、17/28),恶性病灶均以低或无增强为主(91.6％、22/24;100％、24/24)(P＝0.000),良恶性病灶的鉴别诊断符合率为92.3％。良恶性病灶开始增强时间分别为(21.52±6.70)s、(17.82±6.04)s(P＝0.058)。增强峰值时间分别为(46.26±14.97)s、(27.32±8.55)s(P＝0.000),良恶性病灶的鉴别诊断符合率为78.6％。增强模式I型、III型、IV型、VI型在良性病灶和恶性病灶之间的分布差异具有显著性(P＝0.029、P＝0.000、P＝0.036、P＝0.029),良恶性病灶的鉴别诊断符合率为84.1％。在TIC分析中,良性病灶以快升慢降为主(82.6%),恶性病灶以快升快降为主(90.9%)(P＝0.000),良恶性病灶的鉴别诊断符合率为95.1％。结论 根据FLL的CEUS各参数测量,即主要增强时相、TIC、增强峰值时间、增强模式等,特别是前两者,对良恶性FLL的鉴别诊断符合率可达90％以上。CEUS对鉴别FLL具有临床应用价值。 |
| 英文摘要: |
| Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of focal liver lesions (FLL). Methods Thirty-nine patients with 52 focal liver lesions, including 28 benign and 24 malignant,were examined with pulse-inversion harmonic imaging (PIHI) after injection of contrast agent (SonoVue). The CEUS features were studied, including predominant enhancement phases, arrival time of contrast agent, enhancement peak time, enhancement patterns, and time-intensity curve (TIC). The diagnostic consistency rate of differentiation between benign and malignant FLL was calculated respectively. Results In respect of predominant enhancement phases,the high enhancement on CEUS was shown in 75% (21/28) of benign FLL and in 92.6% (22/24) of malignant FLL in arterial phase (P＝0.113). In portal and delayed phases, the high enhancement was seen more often in benign FLL (75%, 21/28; 60.7%, 17/28), while the low or no enhancement was visualized more often in malignant FLL (91.6%, 22/24; 100%, 24/24) (P＝0.000). The diagnostic consistency rate of differentiation between benign and malignant FLL was 92.3%. The arrival time of contrast agent of benign and malignant FLL was (21.52±6.70)s and (17.82±6.04)s (P＝0.058). The enhancement peak time of benign and malignant FLL was (46.26±14.97)s and (27.32±8.55)s (P＝0.000). The diagnostic consistency rate of differentiation between benign and malignant FLL was 78.6%. The stastistical significance was found in benign and malignant FLL of pattern I, pattern III, pattern IV and pattern VI (P＝0.029, P＝0.000, P＝0.036, P＝0.029). The diagnostic consistency rate of differentiation between benign and malignant FLL was 84.1%. TIC of benign FLL was predominantly depicted as a type of fast-up and slow-down curve (82.6%), while that of the malignant was mostly described as a type of fast-up and fast-down curve (90.9%) (P＝0.000). The diagnostic consistency rate of differentiation between benign and malignant FLL was 95.1%. Conclusion There are some helpful CEUS parameters that are predominant enhancement phases, TIC, enhancement peak time and enhancement patterns; in particular, predominant enhancement phases and TIC have a diagnostic consistency rate of more than 90% in the differentiation of benign and malignant FLL. CEUS is useful for the differential diagnosis of benign and malignant FLL. |
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