经引流管腔道内超声造影在引流不畅肝脓肿中的应用  

Application of intracavitary contrast-enhanced ultrasound in liver abscess with inadequate drainage

作　　者：张艳玲[1] 李凯[1] 郭欢仪[1] 苏中振[1] 许尔蛟[1] 郑荣琴[1] 

机构地区：[1]中山大学附属第三医院超声科,广州510630

出　　处：《中华肝脏外科手术学电子杂志》2017年第5期401-404,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家自然科学基金重点项目(81430038);国家自然科学基金(81401434);广东省科技计划项目(2014A020212136);广东省产学研项目(2013B090200020)

摘　　要：目的探讨经引流管腔道内超声造影(IC-CEUS)在引流不畅肝脓肿中的应用价值。方法回顾性分析2011年3月至2015年12月在中山大学附属第三医院行超声引导下置管引流,且怀疑引流不畅的18例肝脓肿患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男13例,女5例;年龄9~78岁,中位年龄48岁。患者均在常规超声引导下行肝脓肿穿刺置管引流,临床观察和常规超声检查怀疑引流不畅,经引流管注入超声造影剂Sono Vue实时超声造影模式下行IC-CEUS,观察引流管位置、脓腔范围、脓腔交通性等。结果 18例患者均可通过IC-CEUS准确显示引流管位置,其中13例引流管在位,3例移位,2例脱位;脓腔存在10例,基本消失3例。常规超声检查仅发现1例引流管在位,脓腔存在6例。对于移位的3例引流管调整引流管位置,脱位的2例重新置入,IC-CEUS检查提示引流管在脓腔内。3例脓腔消失者拔除引流管。结论与常规超声检查相比,IC-CEUS能提供准确的引流管和脓腔信息,可作为置管引流的肝脓肿患者临床观察、治疗和随访的一种重要影像学方法。Objective To investigate the application value of intracavitary contrast-enhanced ultrasound （IC-CEUS） in liver abscess with inadequate drainage. Methods Clinical data of 18 patients with liver abscess who underwent ultrasound-guided drainage and were suspicious of inadequate drainage in the Third Affiliated Hospital of Sun Yat-sen University between March 2011 and December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 13 cases were males and 5 females, aged 9-78 years old with a median age of 48 years old. All patients underwent conventional ultrasound-guided puncture and drainage of the liver abscess. Real-time IC-CEUS was performed by injection of contrast agent SonoVue through the drainage tube when inadequate drainage was suspected by clinical observation and conventional ultrasound examination. The position of drainage tube, the scope and communication of the liver abscess cavity were observed. Results The position of drainage tube was accurately indicated by IC-CEUS in all the patients. The drainage tube was properly located in 13 cases, migrated in 3 and dislocated in 2. The liver abscess cavity was still present in 10 cases and basically absent in 3. Conventional ultrasound examination only found the drainage tube was properly located in 1 case and the liver abscess cavity remained present in 6. The position of drainage tube was adjusted for 3 cases with drainage tube migration, the drainage tube was re-inserted for 2 cases with drainage tube dislocation, and then IC-CEUS indicated that the drainage tube was located in the liver abscess cavity. The drainage tube was extubated for 3 cases with liver abscess cavity disappearance. Conclusions Compared with conventional ultrasound examination, IC-CEUS can provide accurate information of the drainage tube and liver abscess cavity. IC-CEUS can serve as a pivotal imaging approach for clinical observation, treatment and follow-up of the liver abscess

关 键 词：腔内超声检查 超声检查 介入性 造影剂 肝脓肿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.4[医药卫生—诊断学]