融合影像引导超声造影对超声漏诊的肝内异常血供结节的诊断价值  

Application of image fusion guided contrast-enhanced ultrasonography in detecting liver nodules with abnormal blood supply missed by ultrasonography

作　　者：王彦冬[1] 经翔[1] 丁建民[1] 张翔[2] 赵新民[1] 张倩华[1] 

机构地区：[1]天津市第三中心医院超声科天津市人工细胞重点实验室,300170 [2]天津市第三中心医院放射科,300170

出　　处：《中华超声影像学杂志》2013年第9期780-783,共4页Chinese Journal of Ultrasonography

基　　金：天津市卫生局科技基金重点项目（2010KR01）

摘　　要：目的探讨融合影像技术引导超声造影对常规超声及超声造影漏诊的肝内异常血供结节的诊断价值。方法回顾性分析常规超声及超声造影漏诊而增强CT／MRI检出的35例乙肝肝硬化患者共42个肝内异常血供结节，运用融合成像技术将超声与增强CT／MRI图像进行对位融合并引导超声造影，观察融合时间、融合成功率及对常规超声及超声造影漏诊肝内异常血供结节的定位检出率，以及超声造影对肝内异常血供结节的定性诊断率。结果35例患者均成功完成图像对位融合，融合成功率100％，平均融合时间（4．1±1．8）min（1～17min），融合影像引导超声造影共检出40个肝内异常血供结节，定位检出率为95．2％（40／42），1个结节位于右肝顶部因肺气干扰仍无法显示，另1结节位置深在，超声造影显示不清。融合影像引导超声造影定性诊断率为97．5％（39／40），并更改了增强CT对其中2个病灶的诊断结果。结论融合影像引导超声造影对常规超声及超声造影漏诊的肝内异常血供结节具有较高的定位检出率和定性诊断率，为临床完善诊断、指导治疗提供了一种新的途径。Objective To explore the value of image fusion guided contrast-enhanced ultrasonography （CEUS） in detecting liver nodules with abnormal blood supply missed by ultrasonography （US） and CEUS. Methods In 35 patients with HBV cirrhosis, forty-two liver nodules with abnormal blood supply which were missed by US and CEUS but detected by contrast-enhanced CT/MRI were analyzed retrospectively. Image fusion guided CEUS was performed after ultrasound and contrast enhanced CT/MRI images were fused. The fusion time, technical success rate, nodule detection rate and diagnosis accuracy rate were analyzed. Results Image fusion was underwent successfully in all 35 patients, the technical success rate was 100~. Average fusion time was （4.1 ± 1.8）rain（1 - 17 min）. Forty liver nodules with abnormal blood supply were detected by image fusion guided CEUS,and the detection rate was 95.2% （40/42）. One nodule located at the top of right liver was missed because of the influence of lung gas, the other one was invisible due to its deep position. The diagnosis accuracy rate of image fusion guided CEUS was 97.5 ~ （39/40）, and two nodules misdiagnosed by contrast-enhanced CT were diagnosed correctly by image fusion guided CEUS. Conclusions Image fusion guided CEUS had a high detection rate and diagnosis accuracy rate for liver nodules with abnormal blood supply missed by US and CEUS. It can improve the clinical diagnosis and guide interventional procedures.

关 键 词：超声检查 融合影像 微气泡 肝肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]