不同肝背景下原发性肝癌超声造影灌注特征的定量分析  

Quantitative analysis of perfusion features of primary hepatic carcinoma in different hepatic background using contrast-enhanced ultrasound

作　　者：张丽丽[1] 顾金花[1] 齐云峰[1] 赵丽荣[1] 

机构地区：[1]吉林大学第一医院二部超声科,吉林长春130031

出　　处：《吉林大学学报（医学版）》2016年第1期164-167,I0004,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(20110451)

摘　　要：目的:探讨正常肝、肝硬化及脂肪肝背景下原发性肝癌的超声造影表现,定量分析3种肝背景下原发性肝癌的血流灌注特征。方法:选择137例原发性肝癌患者共137个原发病灶,依据肝背景不同分为正常肝背景组(45例)、肝硬化背景组(51例)和脂肪肝背景组(41例)。观察3种肝背景下病灶的超声造影特征;应用时间-强度曲线分析3种肝背景组原发性肝癌的灌注参数,包括始增时间、达峰时间、峰值强度、梯度和灌注期曲线下面积。结果:本组137个病灶均表现为动脉相快速高增强,绝大多数病灶表现为典型的"快进快退"增强模式;但在正常肝背景组有6.7%、肝硬化背景组有31.4%的病灶表现为门脉相和延迟相呈等增强,甚至部分病灶内出现局部高增强的表现,即呈"快进慢退"增强模式;时间-强度曲线分析,3组肝背景下任2组病灶的始增时间、达峰时间、峰值强度、梯度及灌注期曲线下面积比较差异均无统计学意义(P>0.05)。结论:3种肝背景下原发性肝癌的超声造影表现存在差异,但灌注参数无明显差异,应用时间-强度曲线能够客观准确地分析原发性肝癌超声造影的灌注参数,对病灶做出正确诊断。Objective： To investigate the contrast-enhanced ultrasound features of primary hepatic carcinoma in normal liver, cirrhosis liver and fatty liver background, and to quantitatively analyze the blood flow perfusion features of tumors in different hepatic background. Methods.. One hundred and thirty-seven patients with primary hepatic carcinoma including one hundred and thirty-seven primary focuses were selected. The patients were divided into normal liver group （n= 45）, cirrhotic liver group （n= 51） and fatty liver group （n= 41） according the different liver background. The enhancement features of focuses in different hepatic background were observed. The perfusion parameters including rise time, time to peak, maximum of intensity, gradient and area under the curve were analyzed by time-intensity curve. Results.. All leisions of 137 patients presented hyperehcoic enhancement in arterial phase and majority of the lesions presented typically as fast in fast out. 6.7% of leisions in normal liver group and 41.2% of the leisions in cirrhotic hepatic group presented equivalent even hyperechoic enhancement in the portal and delayed phase as fast in and slow out. The perfusion features of tumors such as rise time, time to peak, maximum of intensity, gradient and area under the curve in any two hepatic background groups had no significant differences （P〈0.05）. conclusion.. There are differences in contrast-enhanced ultrasound features of primary hepatic carcinoma with different hepatic background, but there is no significant differences in the perfusion parameters in three groups. The time-intensity curve can analysze the perfusion parameters of contrastenhanced ultrasound of primary hepatic carcinoma objectively, which is helpful for differential diagnosis.

关 键 词：超声造影 肝背景 脂肪肝 肝硬化 肝肿瘤 时间-强度曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]