前纵隔占位的超声及超声造影灌注特征探讨  

Evaluation of the imaging feature of anterior mediastinal tumors with ultrasound and contrast-enhanced ultrasound

作　　者：王凇[1] 杨薇[1] 付静静[1] 白静[1] 尹珊珊[1] 张晖[1] 严昆[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所超声科恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华超声影像学杂志》2016年第4期300-304,共5页Chinese Journal of Ultrasonography

基　　金：北京市卫生系统高层次卫生技术人才培养计划（2013-3-086）;北京市百千万人才工程培养计划

摘　　要：目的分析前纵隔常见的淋巴瘤及胸腺瘤的超声及超声造影特征，与组织病理学类型相比较，总结超声及超声造影的特征。方法2011年4月至2015年3月收集于本院超声造影检查并获得病理诊断的24例前纵隔占位患者（11例纵隔淋巴瘤，5例胸腺癌，8例胸腺瘤），回顾性分析常规超声参数、超声造影灌注特征及造影微血管模式，并分析时间强度曲线参数，比较不同病理类型影像表现及参数的差异性。结果常规超声显示，淋巴瘤与胸腺瘤的病灶形态及内部回声特点比较，差异具有统计学意义（P〈0．05）。超声造影显示，淋巴瘤与胸腺瘤间病灶内微血管显示率、动脉期增强模式差异具有统计学意义（P〈0．05，P〈0．05）；胸腺癌的动脉期增强模式、病灶内坏死显示状态率与胸腺瘤比较差异具有统计学意义（P〈0．01；P〈0．05）。时间强度曲线显示，淋巴瘤的造影剂上升时间（RT）早于胸腺瘤，造影剂强度半降时间（HTw0）晚于胸腺瘤，差异具有统计学意义（P〈0．05，P=0．01）。侵袭性胸腺瘤的造影剂到达时间（AT）晚于非侵袭性胸腺瘤，差异具有统计学意义（P〈0．05）。结论在常规超声对前纵隔占位评价的基础上，超声造影可进一步对肿瘤内部微血管形态、血流灌注状态进行分析，对于纵隔肿瘤鉴别诊断具有一定的临床应用价值和发展潜力。Objective To analysis and summarise the feature of conventional ultrasound（US） and contrast-enhanced ultrasound（CEUS） of anterior mediastinal tumor. Methods From April 2011 to March 2015,24 patients, diagnosed as anterior mediastinal tumor by chest CT and could be detected by conventional US,were enrolled in this study. Among them, there were 11 lymphomas, 5 thymic carcinomas and 8 thymomas. The US and CEUS, micro flow imaging（MFI） and time intensity curve（TIC） parameters were evaluated respectively. Results Compare with lymphoma and thymoma in US, there were significant difference between the tumor shape and internal echo respectively （ P 〈0.05, P〈0.05）. Compare with lymphoma and thymoma in CEUS, there were significant difference between the display rate of mierovascular and feature of enhancement respectively （ P 〈 0.05, P 〈 0.05）. The result of TIC in different tumors were analyzed respectively. The rise time of lymphoma was early than thymoma, but the half time of wash out of lymphoma was later than thymoma, there was significant difference between the two diseases respectively（ P 〈0.05, P = 0.01）. Further more, the arrive time of invasive thymoma was later than noninvasive thymoma, there was significant difference between the two diseases （ P 〈 0.05）. Conclusions CEUS could further assess the characteristic of microvascular perfusion in anterior mediastinal tumors, based on the evaluation of conventional US. It could have a potential clinical value and a development capacity for differentiation diagnosis.

关 键 词：超声造影 纵隔肿瘤 淋巴瘤 胸腺瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]