胃腔充盈下谐波超声造影对胃良恶性病变的诊断价值  

Significance of Oral Ultrasonic Contrast Agent and Harmonic Contrast Enhanced Ultrasound in The Diagnosis of Gastric Benign and Malignant Disease

作　　者：郭君[1] 董超[1] 王敏娜[1] 刘焱[1] 杨帆[1] 

机构地区：[1]航天中心医院超声科,北京市100049

出　　处：《中国超声医学杂志》2011年第7期646-649,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用胃腔充盈下谐波超声造影技术观察胃良恶性病变,探讨胃良恶性病变的超声造影(contrast-enhanced ultrasound,CEUS)血流灌注特征及胃腔充盈下谐波超声造影技术在胃部疾病诊断中的应用价值。方法口服胃充盈声学对比显影剂后二维超声观察胃良恶性病变,再以反向脉冲谐波显像技术对25例胃良恶性病变行实时CEUS检查,对比分析良恶性病变的造影灌注特征。结果口服胃充盈声学对比显影剂后二维超声胃炎表现为胃壁增厚层次可见,溃疡可见胃壁局部凹陷,胃间质瘤见胃壁局限性肿物凸向胃腔,胃癌呈胃壁不规则增厚层次消失。CEUS实时观察,胃炎性病变增厚胃壁与周围正常胃壁同步增强及退出,小溃疡边界更为清晰,较大溃疡CEUS早期可见溃疡底部及周边增厚胃壁内纵行梳齿状的微血管显示,胃间质瘤清晰显示肿物位于胃壁内,胃癌可见病变胃壁快速整体增强,增强顺序紊乱层次不清。结论胃腔充盈下谐波超声造影技术能够很好的显示胃壁全层病变的形态范围,并能结合病变区域微血管灌注情况,对病灶的定位、良恶性鉴别及肿瘤浸润深度有更进一步的判断。Objective To investigate the characteristics of contrast-enhanced ultrasound in the evaluation of per fusion of gastric benign and malignant disease and the value of oral ultrasonic contrast agent and harmonic contrast en hanced ultrasound for the diagnosis of gastric disease. Methods Twenty-five patients with gastric benign and malignant disease were studied through oral ultrasonic contrast agent and pulse inversion harmonic imaging（PIH） tech nique. Then the characteristics of perfusion of all lesions were analyzed. Results Two dimension ultrasonography was used after oral ultrasonic contrast agent was received. Gastritis showed thick gastric wall with clear layers. G-astric ul cer showed the introcession of gastric wall partly. Gastric stromal tumor showed the tumor from gastric wall intruding gastral cavity. Gastric cancer showed thick and irregular gastric wall with unclear layers. Then pulse inversion harmonic imaging technique was used after intravenous bolus injection of SonoVue. Gastritis showed the enhancement and washout of thick and normal gastric wall simultaneously. The boundary of small ulcer was more clear. The bigger ulcer showed the longitudinal capillary vessel in the peripheral and bottom gastric wall of the ulcer in the early phase of CEUS. Gastric stromal tumor showed that the tumor was located in gastric wall. Gastric cancer showed the lesion enhanced fast in disorder form without sequence. Conclusions Oral ultrasonic contrast agent and harmonic contrast en hanced ultrasound can display the form and extent of all layers of gastric wall lesions, and also reveal blood perfusion of lesions in real time, which will be useful for locating the lesions, differential diagnosis and defining distinct infiltrating layers.

关 键 词：胃 胃充盈声学对比显影剂 超声造影 血流灌注 

分 类 号：R445.1[医药卫生—影像医学与核医学]