灰阶超声造影评价胃浸润性病变  

Evaluation of gastric infiltrating lesions with gray-scale contrast-enhanced ultrasonography

作　　者：苗立英[1] 王金锐[1] 张亿倬[1] 舒骏[1] 张晓丽[1] 

机构地区：[1]北京大学第三医院超声诊断科,北京100083

出　　处：《中国医学影像技术》2007年第8期1183-1186,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨灰阶超声造影成像技术评价胃浸润性病变的价值。方法对18例二维超声明确诊断胃壁增厚患者,经静脉团注SonoVue进行胃壁灰阶超声造影。观察并存储注射造影剂后0-3分钟的动态图像,利用定量分析软件进行离机时间-强度曲线（TIC）分析。分别计算达峰时间（AT）、峰值强度变化（A）、TIC曲线的斜率（β）。结果病变位于黏膜下层者,胃壁黏膜下层增强达峰时间较肌层明显提前,斜率变大;全层胃壁病变表现为病变区快速增强,时间在10-16秒,廓清亦较迅速;病变侵及浆膜及浆膜层以外时,浆膜面不光滑、边缘不规则,增强的血管向外延伸;胃壁间囊肿,囊壁与胃壁同步增强,同步廓清,囊腔内无增强征象。结论灰阶超声造影成像技术结合TIC曲线分析,可反映胃壁增厚性病变及肿物的实时血流灌注情况,重点在于能区别病变侵犯层次,对鉴别炎症性病变及肿瘤的分期有一定帮助。　Objective To evaluate the value of gray-scale contrast-enhanced ultrasound in the diagnosis of gastric infiltrating lesions. Methods Eighteen patients with gastric wall thickening were studied with gray scale contrast-enhanced ultrasound. Sonographic images were captured continuously for 3 minutes after a bolus injection of SonoVue （2.4 ml/time） intravenously. Sonographic lesion perfusion images were converted into a lesion perfusion time-intensity curve （TIC） by quantitative analytic software, and parameters such as AT （accelerating time）, A （amplitude of peak intensity）, β （slope rate of the TIC） were calculated. Results Compared with gastric muscular layer, AT was decreasd significantly with submucosal lesions for lesions infiltrated full thickness of gastric wall, they enhanced shortly after contrast intravenous （IV） injection at 10-16 seconds, and washouted quickly. When serosal layer was invaded, serosal layer was enhanced unevenly with irregular margin. To the contrary, cyst within gastric wall only had cystic wall enhanced and washouted synchronously with gastric wall, and there was no sign of enhancement within cyst. Conclusion Gray-scale contrast-enhanced ultrasound with TIC quantitative analysis can reveal blood perfusion of gastric wall lesions in real time, define their distinct infiltrating layer, and estimate if there are perigastric infiltration and lymph nodes metastasis. All these information will be useful for diagnosis and staging of gastric wall lesions.

关 键 词：超声造影 胃 血流灌注 时间-强度曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学] R573[医药卫生—诊断学]