低机械指数连续实时超声造影对肝脏转移癌的诊断价值(1)
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【摘要】 目的 评价低机械指数连续实时超声造影对转移性肝癌病灶发现的诊断价值。方法 对经病理、增强CT/MRI证实86例转移性肝癌的常规超声及低机械指数连续实时超声造影的声像学特点、对新发现的病灶部位、大小等声像图表现进行分析。结果 低机械指数连续实时超声造影较常规超声新发现病灶109个,其中位于膈下、肝圆韧带旁的新病灶36个,占39.2%;直径<10 mm的新病灶44个,占48%;转移性肝癌的特征性造影表现为团块周边门脉相环状增强。结论 低机械指数连续实时超声造影可大大提高肝脏转移癌病灶的检出率,尤其对于常规超声扫查盲区及直径<10 mm的病灶的检出有所助益,并可对患者的转归、进一步治疗提出指导性意见。
【关键词】超声检查;造影剂;肿瘤转移;肝
The application of low-mechanic contrast-enhanced ultasonography in the diagnosis of metastaticcarcinoma of liver
GAO Chuan-jiang,YANGHai-yun,LUO Bao-ming,et al.
Department of Ultrasound in Medicine,Fifth and Second Affiliated Hospital,Sun Yat-Sen University Zhuhai 619000,China
【Abstract】 Objective To assess the value of contrast enhanced ultrasonography (CEUS) and real-time low mechanical index technique in the diagnosis of metastaticcarcinoma of liver. Methods 86 cases ofmetastaticcarcinoma of liver which were proved with enhanced CT and MRI,were performed CEUS by the administration ofSonoVue after examined with conventional ultrasonography(US).The appearances of the lesionsin vascular phases were investigated. The new found lesions which sites and size,etc were analysed.Results The new found number of lesions were 109,36(39.2%) of them lay in subdiaphragm and beside round ligament of liver,the diameterof 44(48%) new found lesions lesser than 1 cm. Their image feature was circular enhancement in the edge of lesions in portal phase. Conclusion CEUS and real-time low mechanical index technique increased diagnostic confidence in the detection and characterization of hepatic metastases compared with standard sonography. Real-time contrast-enhanced sonography is particularly advantageous in detecting small metastases and in the blind area of scanning.May it be benefit for the consequence of patients and direct the therapeutic measures.
【Key words】 Sonographic examination;Bubble agents;Metastaticcarcinoma;Liver
肝脏是最重要的转移癌靶器官之一,对其进行早期发现、诊断对于确定肿瘤分期、选择治疗方案和评估患者的预后有一定的意义。超声造影(contast enhanced ultrasonography,CEUS)技术的出现,是超声成像领域的一大技术性突破。有关超声造影在肝脏占位病变鉴别诊断中的应用国内外已有不少报道。本研究回顾性分析了86例转移性肝癌的常规超声及低机械指数连续实时超声造影的声像学特点、对新发现的病灶部位、大小等声像图表现进行比较,探讨超声造影对肝脏转移癌的诊断价值 ......
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