超声造影对肺癌增强类型的初步研究  

Contrast-enhanced ultrasound of pulmonary carcinoma：a preliminary study

作　　者：罗志艳[1] 刘学明[1] 闻卿[1] 陈娟娟[1] 洪玉蓉[1] 

机构地区：[1]浙江大学医学院附属第二医院超声科,杭州310009

出　　处：《中华超声影像学杂志》2008年第8期690-693,共4页Chinese Journal of Ultrasonography

基　　金：浙江省科技厅一般项目（2005C33001）,浙江省卫生厅一般项目（2005B13069）志谢 感谢本院呼吸内科、胸外科对本研究的支持

摘　　要：目的探讨超声造影在肺癌中的增强表现类型。方法对38例肺癌患者（外周型肺癌28例，中心型肺癌伴阻塞性肺不张10例）进行超声造影，使用时间-强度曲线分析软件记录病灶的始增时间、达峰时间并观察病灶的增强模式。结果28例外周型肺癌病灶中，6～16s之间开始增强24例，平均达峰时间（20．6±4．3）s；4～5s之间开始增强3例，平均达峰时间13．5s；无增强1例。在28例病灶中，以增强程度分类，表现为高增强14例，低增强13例，无增强1例；以造影剂的分布密度分类，表现为不均匀增强17例，均匀增强10例，无增强1例。10例中心型肺癌伴阻塞性肺不张病灶，造影后显示不张的肺组织早在平均4．8s开始增强，平均10．5s时增强达到峰值，而合并的肿瘤平均在10．5s开始增强，平均16．1s时增强达到峰值。结论超声造影有助于鉴别肺囊实性病灶，有助于检出隐藏在肺不张中的肿瘤。Objective To explore the enhancement patterns of pulmonary carcinomas by contrast-enhanced ultrasound（CEUS）. Methods Thirty-eight patients with pulmonary carcinomas proven by pathology [28 with peripheral pulmonary carcinomas and 10 central pulmonary carcinoma with obstructive atelectasis（OA）] were examined by baseline ultrasound and contrast enhanced ultrasound, then the arrival time（AT）, time to peak（TTP） were analyzed with time-intensity curve analysis software and the dynamic enhancement pattern of each lesion was assessed. Results Twenty-four peripheral pulmonary carcinomas demonstrated delayed AT about 6-16 s after application of contrast medium, three lesions demonstrated early AT about 4-5 s and one lesion demonstrated absence of contrast enhancement. The lesions exhibited hyper-, hypo- and non-enhancement were 14, 13 and 1, respectively. Seventeen lesions were heterogenous enhanced with non enhanced necrosis areas and enhanced septa, while ten lesions homogeneous enhanced and one lesion no enhanced. Ten central pulmonary carcinoma with OA demonstrated a characteristic pattern： OA appeared a short AT（mean AT 4.8 s） until enhancement and strong contrast enhancement,while the central tumors appeared a delayed AT （mean AT 10.5 s） and faint enhancement. Conclusions CEUS can be useful in differentiation between solid and cystic pulmonary lesions,and detection of the latent lesions underlying the atelectasis.

关 键 词：超声检查 微气泡 肺肿瘤 

分 类 号：R686[医药卫生—骨科学]