肝脏良恶性肿瘤血流灌注的超声造影定量评价  

Quantitative Assessment of Contrast-enhanced Ultrasound in Perfusion of Hepatic Benign and Malignant Tumors

作　　者：赵玉珍[1] 董超[2] 刘红磊[2] 祝晓东[1] 赵小华[1] 王瑛[1] 

机构地区：[1]卫生部中日友好医院超声科,北京市100029 [2]河北医科大学第四医院超声科

出　　处：《中国超声医学杂志》2007年第5期360-363,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河北省科技厅重点攻关项目(No.05276101D69);卫生部中日友好医院科研项目(No.20060712)

摘　　要：目的探讨超声造影(CEUS)定量参数评价肝脏良恶性肿瘤的血流灌注特征。方法应用反向脉冲谐波显像(PIHI)技术实时观察50例肝肿瘤CEUS动脉相血流灌注增强方式,并通过时间-强度曲线(TIC)定量参数对肝肿瘤血流灌注进行定量评估。结果整体不均匀型、整体均匀型为30例肝脏恶性肿瘤动脉相主要灌注增强方式,周围向心型为20例肝血管瘤动脉相主要灌注增强方式。恶性病灶TIC形态快升快降,波峰尖锐;良性病灶TIC形态缓升慢降,波峰圆钝;恶性病灶较良性病灶增强时间(AT)明显缩短,TIC斜率(β)增大,A(峰值强度变化)·β值恶性病灶(55.01±42.36)较良性病灶(22.89±19.60)显著增高(P<0.001)。结论CEUS定量参数AT、β、A·β值能够反映肝肿瘤微小血管血流分布情况及灌注量特点,可用于肝良恶性肿瘤血流灌注的鉴别诊断。Objective To investigate the characteristics of the acoustic quantified parameters of contrastenhanced ultrasound in the perfusion evaluation of hepatic benign and malignant tumors. Methods The perfusion patterns of 50 patients with hepatic tumors in the arterial phase was observed with pulse inversion harmonic imaging （PIHI） technique. The perfusion quantity of hepatic tumors was analyzed according to the acoustic quantified parameters on the time-intensity curve （TIC） . Results A global inhomogeneous and homogeneous enhanced pattern was the main pattern of perfusion in 30 cases with the malignant lesions. A peripheral and centripetal enhanced pattern was mostly shown in 20 cases with hamangiomas. TIC appeared slow-up and slow-down types in the benign lesions, but quick-up and quick-down types in the malignant lesions. As compared with the benign lesions, the accelerating time （AT） in the malignant lesions were significantly shorter. The ascending slope of the curve （β） and the product of A （amplitude of peak intensity） and β in the malignant lesions were significantly higher than those in the benign lesions （P〈0. 001） . Conclusions The acoustic quantified parameters including the accelerating time （AT）, the ascending slope of the curve （β） and the product of A and β of contrast-enhanced ultrasound can reflect the flow distribution and the quantity of perfusion in hepatic tumor to differentiate the hepatic benign and malignant tumors.

关 键 词：超声造影 肝肿瘤 血流灌注 定量分析 

分 类 号：R735.7[医药卫生—肿瘤]