肝内胆管细胞癌超声造影研究  

Clinical Study on Contrast-enhanced Ultrasound Diagnosis of Intrahepatic Cholangiocarcinoma

作　　者：陈重[1] 邓旦[1] 李茜[1] 胡玫[2] 陶杰[1] 廖明松[1] 吴晓波[1] 

机构地区：[1]成都军区总医院超声科,成都市610083 [2]中国人民解放军第三零二医院信息科

出　　处：《中国超声医学杂志》2013年第9期798-802,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨低机械指数实时超声造影技术应用于肝内胆管细胞癌(intrahepaticcholangiocarcinama,ICC)的造影表现及诊断价值。方法通过常规超声及超声造影技术(contrast-enhanced ultrasound,CEUS)对22例患者肝内的29个病灶进行检查,记录病灶二维超声特点,观察超声造影各时相增强特点,并与病理结果进行对照,然后进行统计分析。结果(1)肝内胆管细胞癌二维超声表现多样。(2)超声造影动脉相共观察到4种增强模式:①动脉相病灶整体高增强(20.69%);②动脉相不均质稍高增强(55.17%);③动脉相呈不均质低增强,中心大部分区域呈无增强,仅见树枝状稀疏血管伸人其中(10.34%);④动脉相呈周边环状高增强(13.8%)。(3)病灶增强模式与病灶大小关系:长径≤2.5 cm的病灶动脉相多呈整体高增强,>2.5 cm的病灶则以不均质稍高增强为主(P<0.000 1)。长径≤2.5 cm的病灶门脉相多呈低增强,>2.5cm者多呈等增强(P<0.0001);延迟相:病灶均呈低增强表现。(4)超声造影动脉相高增强部分,病理结果显示其内癌细胞较多,血管较丰富。造影示动脉相浅淡增强或充盈缺损部分,病理表现其成分以纤维组织为主,其内稀疏分布的血管,同时可见灶状坏死。结论 ICC超声造影表现具有一定的特征性,超声造影技术对其诊断具有重要价值。Objective To investigate the value of contrast-enhanced ultrasonography （CEUS） in diagnosis of intrahepatie cholangiocarcinama（ICC）. Methods We observed ultrasound characteristics of 22 patinents with 29 ICCs using conventional ultrasound and CEUS and then compared them with corresponding pathological examination results. Results （1） The Two dimensional Ultrasound Imaging of ICCs showed variety. （2） Four enhancement patterns were observed in the arterial phase for 29 mass of ICCs： （1）tota] hyper-enhancement（20, 69%）; （2）slightly hyper-enhance ment （ 55.17% ） ; （3） heterogeaous bypo enhancement （ 10. 34 %）. （4） peripheral r/m-like hyper-enhaneement （ 13.8 % ）. （3） The dimension of the lesions played an important role in the perfusion patterns. The ICCs diameter≤2.5 cm in the arterial phase were mainly total hyper-enhancement and the ICCs diameter~〉2.5 cm mainly presented heterogeneous hypo-enhancement（P^0. 000 1） . The most of ICCs in the portal phase were hypo enhancement, and the rest were iso- enhancement（P〈0. 000 1）. All of them were hypo-enhancement in the late phase. （4） Pathological components of the hyper-enhancement areas detected by CEUS were rich in tumor cells, and of the homogeneous hypo-enhancement region were mainly fibrous tissues. We also observed discrete blood vessels and necrotic foei in the region of low-level echo. Conclusions It is presumed that conventional ultrasound combined with CEUS could improve the outcomes of diagnosis of ICC.

关 键 词：超声造影 肝内胆管细胞癌 病理 

分 类 号：R735.8[医药卫生—肿瘤]