双重超声造影诊断大肠肿瘤的临床价值  

The Diagnostic Value of Double Contrast Enhanced Ultrasound in Colorectal Neoplasms

作　　者：敬基刚[1] 庄华[1] 彭玉兰[1] 罗燕[1] 

机构地区：[1]四川大学华西医院超声诊断科,成都610041

出　　处：《四川大学学报（医学版）》2016年第5期800-804,809,共6页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金青年基金(No.81101061)资助

摘　　要：目的探讨双重超声造影检查对于大肠肿瘤的诊断价值。方法回顾性分析比较经手术病理证实的77例(79枚肿瘤)大肠肿瘤的经腹壁常规超声检查、双重超声造影检查(大肠腔内灌注超声检查+静脉超声造影检查)患者影像学资料及临床病理学资料。结果双重超声造影检查发现68例大肠肿瘤(68/79,敏感性为86.1%);经腹壁常规超声检查发现病灶32例(32/79,敏感性为40.1%)。经腹壁常规超声检查法的定位准确率为21.9%(7/32),双重超声造影检查法对大肠肿瘤的定位准确率为88.2%(60/68),对结肠肿瘤的定位准确率为94.4%(51/54)。双重超声造影在检测敏感性和定位准确性上高于常规超声(P<0.05)。双重超声造影检查时,大肠肿瘤强化的模式有两种:瘤体整体均匀性强化,本组31例;或瘤体不均匀性强化,瘤体内部可见始终无强化区,本组37例。大肠肿瘤强化的模式与肿瘤的二维形态或生长方式有关:节段性增厚者从浆膜面朝向黏膜面逐步垂直地强化,本组39例;隆起型病变者造影剂由蒂部或者基底部进入,本组29例。结论双重超声造影检查法较常规超声检查发现病变的敏感性、定位准确性高,有潜力成为大肠肿瘤的常规影像诊断方法或术前评估方法。Objective To determine the value of double contrast enhanced ultrasound （DCEUS） in detecting colorectal neoplasms. Methods The conventional abdominal ultrasound and DCEUS （hydrocolonal ultrasound-I intravenous contrast-enhanced ultrasonography） were performed in 77 patients with 79 colorectal tumors. The clinical, ultrasonic and pathological data of the patients were reviewed. Results The conventional abdominal ultrasound detected 32 colorectal tumors （32/79, with a sensitivity of 40.1 ~/00）, compared with 68 tumors found in DCEUS （68/79, with a sensitivity of 86. 1~）. The tumors were located accurately in 21.9~ （7/32） and 88.2~ （60/68） cases for the conventional abdominal ultrasound and DCEUS, respectively （P^0.05）. DCEUS accurately located 94. 4~ （51/54）cased with colon neoplasm. Two types of enhancing modes were found with colorectal neoplasm ： entirely homogeneous enhancing and heterogeneous enhancing perpendicularly from the serosal part to the mueosal part. The enhancing modes were associated with the morphology of neoplasm. Thirty nine segmented- thickened tumors were found with perpendicularly enhancing from the serosal surface to the mucosal surface, while 29 protruding tumors were found with enhancing from their pedicles or fund. Conclusion DCEUS has higher detection sensitivity and location accuracy than conventional ultrasound.

关 键 词：大肠肿瘤 双重超声造影 梗阻性 

分 类 号：R735.34[医药卫生—肿瘤] R445.1[医药卫生—临床医学]