动态血管模式在肝局灶性病变超声造影鉴别诊断中的应用价值  

Application of dynamic vascular patterns in differential diagnosis of focal liver lesions in contrast-enhancedultrasound

作　　者：张春莉[1,2] 陈文卫[1] 柏刚[1] 陈辽[1] 黄慧 

机构地区：[1]武汉大学人民医院超声影像科,430060 [2]湖北省中山医院超声科

出　　处：《中华超声影像学杂志》2013年第3期226-230,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨动态血管模式（dynamicvascularpatterns，DVP）曲线及参数图在肝局灶性病变超声造影中的应用价值。方法利用SonoLiver软件对83例接受超声造影检查并经病理或临床确诊的肝局灶性病变患者资料进行定量分析，获得时间一强度曲线（time-intensitycurve，TIC）及DVP曲线，构建DVP参数图，并计算出TIC相关参数。结果TIC参数：上升时间（RT）、达峰时间（TTP）、峰值强度（IMAX）、平均渡越时间（mTT）、上升斜率及半降斜率绝对值在良恶性病变组间差异有统计学意义（P〈0．05）。DVP曲线波形分四种类型：Ⅰ型（正负双向波）、Ⅱ型（正向波）、Ⅲ型（负向波）及Ⅳ型（负正双向波）。94．9％Ⅰ型为恶性病变，100％Ⅳ型为良性病变。Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型分别在恶性、良性病变中占72．5％、13．7％、13．7％及0和6．2％、43．8％、31．2％、18．8％。DVP参数图分型特征及在良恶性病变中所占比例均与DVP曲线一致。结论动态血管模式DVP曲线及参数图直观反映了病变区与周围肝实质血流灌注的差异，为肝局灶性病变的鉴别诊断提供了新的定性指标。Objective To explore the application value of dynamic vascular patterns（DVP） curve and parameter figure in the focal liver lesions by contrast-enhanced ultrasound（CEUS）. Methods 83 cases of focal liver lesions diagnosed by pathologically or clinically that had undergone CEUS were analyzed by SonoLiver software. Then DVP parametric images were constructed and the time-intensity curve （TIC） parameters were calculated by TIC and DVP curve. Results Rise time（RT） ,time to peak（TTP） ,maximum intensity（IMAX）, mean transit （mTT）,slope of rise, and the absolute value for slope of half down between malignant and benign lesions groups indicated statistically significant difference （ P d0.05）. 94.9% of type was malignant lesions and 100% Ⅳ type was benign lesions. The four types of DVP curve（ Ⅰ , Ⅱ ,Ⅲ, Ⅳ ） in malignant and benign lesions were 72.5%, 13.7%, 13.7%,0 and 6.2%,43.8%,31.2%, 18.8%, respectively. The proportion and characteristic of DVP parametric images and DVP curves in malignant and benign lesions groups were consistent. Conclusions DVP curve and parametric images of CEUS can demonstrate the difference of flow perfusion static between lesions area and surrounding liver parenchyma dynamically and directly. These are new qualitative indexes of the differential diagnosis in focal liver lesions.

关 键 词：超声检查 微气泡 肝肿瘤 动态血管模式 

分 类 号：R445.1[医药卫生—影像医学与核医学]