转移性小肝癌超声造影表现特征  

Characterization of small liver metastasis with contrast-enhanced ultrasonography

作　　者：张小龙[1] 王文平[1] 董怡[1] 黄备建[1] 陆清[1] 毛枫[1] 

机构地区：[1]复旦大学附属中山医院超声科上海市影像医学研究所,上海200032

出　　处：《中华医学超声杂志（电子版）》2016年第2期134-138,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金项目(81371577)

摘　　要：目的探讨转移性小肝癌的超声造影表现特征。方法回顾性分析复旦大学附属中山医院94个转移性小肝癌病灶及150个小肝细胞癌(HCC)病灶的超声造影图像,对比2组病灶超声造影的增强方式和时相变化(增强时间、达峰时间、等回声时间、低回声时间)。结果 94个转移性小肝癌病灶中,66.0%(62/94)表现为整体增强,34.0%(32/94)表现为环状增强;150个小HCC病灶中,98.7%(148/150)表现为整体增强,1.3%(2/150)表现为环状增强,转移性小肝癌动脉期环状增强的比例显著高于小HCC(P<0.01)。转移性小肝癌的超声造影等回声时间、低回声时间、从等回声至低回声所经历的时间分别为(28.7±6.3)s、(39.1±16.2)s、(8.2±8.5)s;小HCC的超声造影等回声时间、低回声时间、从等回声至低回声所经历的时间分别为(35.8±12.5)s、(86.8±45.5)s、(52.5±44.2)s,转移性小肝癌的超声造影等回声时间、低回声时间及从等回声至低回声所经历的时间均短于小HCC(t=-8.722、-12.636、-10.571,P值均<0.01)。结论整体增强和环状增强均为转移性小肝癌的常见表现,增强方式和减退时间有助于转移性小肝癌和小HCC的鉴别,超声造影有助于转移性小肝癌的诊断。Objective To characterize the features of small liver metastasis with contrast-enhanced ultrasound（CEUS）. Methods Ninty-four small liver metastasis and 150 small hepatocellular carcinoma（HCC） in Zhongshan Hospital were analyzed on CEUS. Enhancement patterns, the time to enhancement, time to peak, time to isoechogenity and time to hypoechogenity were compared between small liver metastasis and HCC. Results Ninty-four small liver metastasis showed total enhancement and rim-like enhancement at arterial phase, and the incidences were 66.0%（62/94） and 34.0%（32/94）, respectively. One hundred and fifty small HCC showed total enhancement and rim-like enhancement at arterial phase, and the incidences were 98.7%（148/150） and 1.3%（2/150）, respectively. Small liver metastasis had a significantly higher proportion of rim-like enhancement than that of small HCC（P〈0.01）. The time to isoechogenity, time to hypoechogenity and time from isoechogenity to hypoechogenity of small liver metastasis were shorter than those of small HCC, which were（28.7±6.3） s,（39.1±16.2） s,（8.1±8.5） s and（35.8±12.5） s,（86.8±45.5） s,（52.5±44.2） s, respectively（t=-8.722,-12.636 and-10.571, all P〈0.01）. Conclusions Both of the total and rim-like enhancement are common enhancement patterns of small liver metastasis in CEUS. Both of enhancement pattern and washout time are useful in differential diagnosis of small liver metastases and small HCC. CEUS can help to diagnose small liver metastasis.

关 键 词：超声检查 造影剂 肝肿瘤 肿瘤转移 

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]