超声造影定量分析评估门静脉癌栓对肝癌血流动力学的影响  

Quantitative Perfusion Analysis of Contrast-Enhanced Ultrasound:the Influence to Hepatocellular Carcinoma Hemodynamic by Portal Vein Tumor Thrombosis

作　　者：王竹[1,2] 刘广健[1,2] 吕明德[1,2] 谢晓燕[1,2] 王伟[1,2] 徐作峰[1,2] 林满霞[1,2] 黄漾[1,2] 

机构地区：[1]中山大学附属第一院超声科 [2]中山大学超声诊断与介入超声研究所,广东广州510080

出　　处：《中山大学学报（医学科学版）》2014年第3期396-401,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81271576;30770567);广东省医学科研基金(A2013194)

摘　　要：【目的】探讨超声造影(CEUS)定量分析在门静脉癌栓(PVTT)对原发性肝癌(HCC)血流动力学影响中的价值。【方法】回顾性分析7例HCC合并PVTT和14例HCC未合并PVTT患者的超声造影动态图像,以SonoLiverTM定量软件进行分析,获得肝癌与周围肝实质的时间-强度曲线,最大峰值强度(IMAX)、上升时间(RT)、平均渡越时间(MTT)、达峰时间(TTP)分别于组内及组间进行比较。【结果】①组内比较:PVTT组和对照组中HCC的RT和TTP均快于周围肝实质。对照组HCC的IMAX显著高于周围肝较强,而PVTT组中,HCC的IMAX与周围肝实质无显著性差异。②组间比较:PVTT组的RT和TTP无论HCC还是肝实质,均快于对照组。而在PVTT组HCC的IMAX较对照组显著降低。【结论】HCC合并PVTT后与对照组有着不同的血流动力学参数,其RT和TTP增快、IMAX减低,这可能为微小癌栓的预测提供一定的临床价值。[Objectives] To evaluate the value of quantitative analysis of contrast-enhanced ultrasound （CEUS） in which the influence to hepatocellular carcinoma （HCC） hemodynamic by portal vein tumor thrombosis （PVTT）.[Methods] Seven HCC patients with PVTT and another 14 without PVTT underwent CEUS using sulfur hexafluoride microbubbles.Dynamic images were analyzed with quantification software.Time-intensity curves were obtained for HCC and surrounding liver parenchyma,and the following parameters including intensity maximum （IMAX）,rising time （RT）,mean transit time （MTT）,time to peak （TIP） were compared within and between PVTT and control groups,respectively.[Results] RT and TTP of HCCs were significantly faster than surrounding liver parenchyma in both PVTT and control groups.IMAX of HCCs was significantly stronger than surrounding liver in control group,but not significantly different from liver parenchyma in PVTT group.RT and TTP of HCCs and surrounding liver were significantly faster in PVTT group compared with control group,while IMAX of HCCs in PVTT group significantly lower than those in control group.[Conclusions] HCCs with PVTT present different hemodynamic parameters,with faster RT,TTP and lower IMAX than those without PVTT.

关 键 词：肝细胞癌 门静脉癌栓 超声造影 定量分析 

分 类 号：R455.1[医药卫生—运动医学] R735.7[医药卫生—治疗学]