肝细胞癌的灰阶超声、彩色多普勒超声和超声造影的对比研究  

Contrast-enhanced ultrasound, gray-scale ultrasound and color Doppler flow imaging in hepatocellular carcinoma

作　　者：陈晓宇[1] 赵宝珍[1] 王伟[1] 陆世萍[1] 

机构地区：[1]第二军医大学长海医院超声科,上海200433

出　　处：《中国医学影像技术》2006年第2期189-192,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的通过肝细胞癌(HCC)的灰阶超声、彩色多普勒超声(CDFI)和超声造影(CEUS)诊断的对比研究,探讨超声造影在肝细胞癌诊断中的优势。方法肝细胞癌患者20例,共26个病灶,均经手术或穿刺活检病理证实为肝细胞癌;分别用灰阶超声、彩色多普勒超声和超声造影检查,观察肿瘤的大小、回声强度、肿瘤内的血管和肿瘤实质的血流灌注。结果在肿瘤结节的形态上,超声造影与灰阶超声基本相似,但在肿瘤直径和面积的测值上,超声造影大于灰阶超声,存在显著差异(P<0.01),而且可以发现灰阶超声所不能显现的病灶。超声造影与彩色多普勒均显示肿瘤的血管和血供,但在显示肿瘤的微血管和血流灌注时,超声造影明显优于彩色多普勒(P<0.01)。肝细胞癌超声造影血管相的增强方式与细胞分化程度有一定的相关性。结论超声造影是实时、有效显示肝细胞癌肿瘤血管和血流灌注的方法。在HCC探测和定性方面明显优于灰阶超声和彩色多普勒超声,而且对肝细胞癌的恶性程度可做出一定的判断。Objective To compare contrast-enhanced ultrasound （CEUS） to gray-scale ultrasound and color Doppler flow imaging （CDFI）, and evaluate the advantages of CEUS in the diagnosis of hepatocellular carcinoma （HCC）. Methods Twenty patients with 26 hepatocellular carcinoma lesions diagnosed by surgery or biopsy were scanned with gray-scale ultrasound, CDFI and CEUS separately. The size, echo intensity, intratumoral vascularity of tumors and the perfusion of tumors parenchyma during the vascular phase were monitored. Results In HCC morphology, the imaging of CEUS was similar to that of gray-scale ultrasound, but in the aspect of the diameter and areas of the tumor, CEUS displayed greater results than gray-scale ultrasound did. There was significant difference between them （P〈0.01）. CEUS could detected the liver lesions that gray-scale ultrasound could not. Both CDFI and CEUS revealed the vascularity and perfusion of HCC, but the result of CEUS was significantly superior to that of CDFI （P〈0.01）. The enhancement pattern of HCC with CEUS in the vascular phase was correlated with the degree of cellular differentiation. Conclusion CEUS is real-time, effective approach in revealing the intratumoral vascularity and the perfusion of HCC. The detection and characterization of HCC with CEUS are superior to those of gray-scale ultrasound and CDFI.

关 键 词：超声检查 造影剂 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤] R814.43[医药卫生—临床医学]