齐旭,唐少珊,金虹,刘站.经直肠超声造影鉴别诊断直肠癌与直肠间质瘤[J].中国医学影像技术,2015,31(3):425~428
经直肠超声造影鉴别诊断直肠癌与直肠间质瘤
Transrectal contrast-enhanced ultrasound in differential diagnosis ofrectal cancer and rectal gastrointestinal stromal tumor
投稿时间:2014-08-20  修订日期:2014-11-27
DOI:10.13929/j.1003-3289.2015.03.028
中文关键词:  直肠肿瘤  胃肠道间质瘤  超声检查  造影剂
英文关键词:Rectal neoplasms  Gastrointestinal stromal tumor  Ultrasonography  Contrast media
基金项目:
作者单位E-mail
齐旭 中国医科大学附属盛京医院超声科, 辽宁 沈阳 110004  
唐少珊 中国医科大学附属盛京医院超声科, 辽宁 沈阳 110004 tangss@sj-hospital.org 
金虹 中国医科大学附属盛京医院超声科, 辽宁 沈阳 110004  
刘站 中国医科大学附属盛京医院超声科, 辽宁 沈阳 110004  
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中文摘要:
      目的 探讨经直肠CEUS鉴别诊断直肠癌与直肠间质瘤的价值。方法 选取接受手术切除的直肠肿瘤患者44例,根据术前经直肠CEUS检查结果分为直肠癌组29例和直肠间质瘤组15例,另设同种肿瘤周围正常肠壁分别为对照1组和对照2组。观察造影剂在直肠肿瘤患者的充盈灌注情况,并与各自相应对照组比较。以对照组为参照,采用SonoLiver分析软件绘制肿瘤与正常肠壁的时间强-度曲线(TIC),并对曲线形态和峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)及平均渡越时间(mTT)进行比较。结果 与各自相应对照组比较,直肠癌组总体造影表现为"快进快出"的高增强模式,直肠间质瘤组表现为"慢进慢出"的低增强模式。直肠癌组IMAX值高于对照1组[(122.42±15.99)% vs 100%],而RT[(6.02±1.54)s vs (8.01±1.63)s]、TTP[(8.30±1.59)s vs (10.73±3.03)s]、mTT[(14.40±2.51)s vs (18.77±4.14)s]均小于对照1组(P均<0.05);直肠间质瘤组IMAX低于对照2组[(55.40±8.33)% vs 100%],而RT[(9.73±1.61)s vs (7.50±1.82)s]、TTP[(18.03±1.91)s vs (9.51±1.24)s]、mTT[(20.17±23.10)s vs (17.92±1.81)s]均大于对照2组(P均<0.05)。结论 直肠癌与直肠间质瘤的CEUS表现存在明显差异,结合TIC和造影参数,有助于鉴别直肠癌和直肠间质瘤。
英文摘要:
      Objective To investigate the value of transrectal contrast-enhanced ultrasound (CEUS) in differential diagnosis of rectal cancer and gastrointestinal stromal tumors. Methods Forty-four cases with colorectal neoplasm resection rectal were selected and divided into rectal cancer group (n=29) and stromal tumor group (n=15) according to the result of CEUS pre-operation. Moreover, around the same neoplasm normal bowel wall were set as control group 1 and control group 2, respectively. The perfusion features of lesions were observed and compared with each of control group. SonoLiver software was used to draw the time intensity curve (TIC) of neoplasm and normal bowel wall, and the pattern and maximuintensity (IMAX), rise time (RT), time to peak (TTP) with meantransittime (mTT) were compared. Results Compared with each of control group, the enhance mode showed hyper-enhanced with a "fast in fast out" pattern in rectal cancer group, and lypo-enhanced with a "slow in and slow out" pattern in stromal tumor group. The IMAX was higher in rectal cancer group than in control group 1 ([122.42±15.99]% vs 100%), [JP+1]but the RT ([6.02±1.54]s vs [8.01±1.63]s),[JP]
TTP ([8.30±1.59]s vs [10.73±3.03]s), mTT ([14.40±2.51]s vs [18.77±4.14]s) was lower (all P<0.05). The IMAX was lower in control group 2 than in stromal tumor group ([55.40±8.33]% vs 100%), but RT ([9.73±1.61]s vs [7.50±1.82]s), TTP ([18.03±1.91]s vs [9.51±1.24]s), mTT ([20.17±23.10]s vs [17.92±1.81]s) were higher (all P<0.05). Conclusion There is significant difference in rectal cancer and rectal gastrointestinal stromal tumor on CEUS. Combination of CEUS parameters and TIC can help to differential diagnosis of rectal cancer and rectal gastrointestinal stromal tumor.
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