超声造影与CT在非霍奇金淋巴瘤脾脏浸润灶诊断中的比较  

Comparison between Contrast-enhanced Ultrasonography and CT in Diagnosis of Spleen Infiltration Lesions in Non-Hodgkin's Lymphoma

作　　者：郑笑娟[1] 王洪梅[1] 杨序春[2] 史晓龙[1] 李春生[3] 蒋勇[4] 

机构地区：[1]舟山市人民医院特技科,浙江省舟山市316000 [2]舟山市人民医院血液科,浙江省舟山市316000 [3]舟山市人民医院病理科,浙江省舟山市316000 [4]厦门大学附属中山医院心超室

出　　处：《中国超声医学杂志》2008年第9期824-827,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价超声造影与CT在非霍奇金淋巴瘤(NHL)脾脏浸润灶诊断中的价值。方法7例非霍奇金淋巴瘤(NHL)患者32个脾脏浸润灶首先应用常规超声观察脾内病灶的部位、范围及内部回声,然后接受超声造影检查(CEUS),采用造影剂SonoVue和低机械指数成像技术对比脉冲序列(CPS),观察脾内浸润灶的数量、部位、范围及造影增强特征,并与增强CT、病理学检查进行对照分析。结果NHL脾脏浸润灶增强典型图像改变:"筛孔状"增强;无增强;"虫蚀样"增强,超声造影可清晰显示脾内浸润灶的部位、形态、范围,其显示脾内浸润灶的敏感性为100%(32/32)。增强CT可显示脾内的23个浸润灶,敏感性为71.87%(23/32),超声造影显示此CT遗漏的9个浸润灶均<8 mm,超声造影敏感性高于增强CT(P<0.01)。在判断脾内浸润灶的存活情况,超声造影与病理学检查具有较好的一致性。结论NHL脾脏浸润灶CEUS增强模式具有特征性,超声造影技术可显著提高超声对脾脏浸润灶的诊断水平,和增强CT比较具有一定的优势。Objective To compare the diagnostic value of contrast-enhanced ultrasonography with CT in Non- Hodgkin＇s lymphoma （NH2） . Methods Thirty-two spleen lesions of NHI. in 7 patients was examined first with conventional ultrasound to observe the area, scope and inner echoes, infiltration lesion, then examined with contrast- enhanced ultrasound （CEUS）, combined both contrast medium SonoVue and low mechanical index CPS, in order to observe the amount, position, scope and enhancement features of the spleen infiltration lesions. After that, a contrastive analysis was made between the results of CEUS, enhanced-CT and pathological findings. Results The features of contrast-enhanced images demonstrated： sponge-like enhancement in spleen lesions, The minority cases had deposition of contrast agent. Conclusions： Contrast-enhanced ultrasound is a valuable tool for the spleicn infiltration lesions of non-Hodgkin＇s lymphoma and also can give a guidance on therapy. The contrast-enhanced images of spleenic infiltration lesions of NHL varied： sponge-like enhancement; no enhancement;＂ worm-eaten＂ enhancement. The position, morphology, range of the splenic infiltration lesions were clearly displayed on the ultrasound images. The sensitiv!ty of CEUS detecting the infiltration lesions was 100% （32/32）, compared with that of CT scan-- 71. 87 % （23/32）, which the sensitivity could only display 23 lesions, but 9 misdiagnosed lesions （〈 8mm） on CT were clearly displayed on CEUS, in which was significantly higher than that of CT scan （P〈0. 01） . All the enhancement areas were ＂ fast entering and slowly exiting＂, but emptying is markedly earlier than those normal splenic tissues. The grades of splenic infiltration lesions evaluated by CEUS were consistent with pathology to judge the survival. Conclusions In CEUS enhancement images of NHL spleen infiltration lesions have typical features, which can remarkably improve the ultrasound diagnostic accuracy and is superior to CT.

关 键 词：非霍奇金淋巴瘤 脾脏浸润灶 超声造影 增强特点 CT检查 

分 类 号：R733.1[医药卫生—肿瘤]