超声造影在肝硬化增生小结节定性诊断中的应用价值  

Application of contrast-enhanced ultrasonography used in qualitative diagnosis of regenerative nodules in cirrhotic liver

作　　者：董晓秋[1] 邵小慧[1] 徐春媚[1] 

机构地区：[1]哈尔滨医科大学第四临床医学院超声科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2009年第3期279-281,284,共4页Journal of Harbin Medical University

基　　金：黑龙江省卫生厅科学技术研究项目资助(2005-241)

摘　　要：目的探讨超声造影(CEUS)模式及定量参数在肝硬化增生小结节(SRNs)诊断中的应用价值。方法对32例(46个病灶)经细针穿刺有病理结果的SRNs(直径≤3 cm)的超声造影结果进行回顾性分析,对实时超声造影图像运用时间-强度曲线进行定量分析,并比较SRNs造影前后诊断率。结果SRNs超声造影呈4种灌注模式:模式1"同进同出"(26/46);模式2"慢进同出"(16/46);模式3"快进慢出"(3/46);模式4"无增强"(1/46)。时间-强度曲线分析,SRNs与肝实质上升支斜度、下降支斜度、平均强度之间差异有统计学意义,峰值时间差异无统计学意义。常规超声的诊断率为65.79%,超声造影的诊断率为88.37%。结论CEUS可有效动态地评价SRNs的新生血管情况,对SRNs检出率高于常规超声,可进行定性、定量诊断,同时可对血流灌注特点进行分析;超声造影对有恶变倾向的SRNs的早期诊断具有更重要的临床意义。Objective To analysis the application of contrast-enhanced uhrasonography used in qualitative diagnosis of regenerative nodules in cirrhotic liver. Methods Contrast-enhanced uhrasonography was performed on 32 patients with SRNs which had pathologic diagnosis from biopsy. The enhancement pattern was analyzed by time-intensity curves,then the diagnostic accuracy of CEUS was compared with conventional ultrasound. Results The enhancement patterns were classified as the following 4 types： Type Ⅰ ＂enhanced simultaneously and presented the isoecho with the liver＂ （26/46） ;Type Ⅱ ＂slow-in and become the isoecho in parenchymal phase＂ （16/46） ;Type Ⅲ＂fast-in and slow-out＂ （3/46） ;Type Ⅳ ＂no enhancement＂ （1/46）. Slope of upslope and decent, average intensity in SRNs had significant deviation with liver parenchyma. Time-to-peak had no significant deviation with no liver parenchyma. The diagnostic accuracy of conventional sonography was 65.79% , the diagnostic accuracy of CEUS was 88.37%. Conclusion The diagnostic accuracy of CEUS is superior to conventional sonography,it can evaluate the vascularization in SRNs effectively,especially SRNs that conventional sonography can not find. CEUS is important for SRNs that are malignant tentatively.

关 键 词：超声造影 肝硬化 增生小结节 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]