超微血管显像与超声造影在诊断膀胱占位性病变中的临床价值  

Clinical value of superb microvascular imaging and contrast-enhanced ultrasound in diagnosis of bladder occupied lesions

作　　者：刘启平[1] 陈红燕[1] 朱慧[1] 龚会凌[1] 朱丽[1] 刘莹[1] 黄晓宇[1] 周燕[1] 杨宁[2] 陈永其[3] LIU Qiping;CHEN Hongyan;ZHU Hui;GONG Huiling;ZHU Li;LIU Ying;HUANG Xiaoyu;ZHOU Yan;YANG Ning;CHEN Yongqi(Department of Ultrasound,Minhang Hospital,Fudan University,Shanghai 201199,China;Department of Urology,Minhang Hospital,Fudan University,Shanghai 201199,China;Department of Pathology,Minhang Hospital,Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行医院超声科,上海201199 [2]复旦大学附属闵行医院泌尿外科,上海201199 [3]复旦大学附属闵行医院病理科,上海201199

出　　处：《肿瘤影像学》2018年第6期466-470,共5页Oncoradiology

基　　金：上海市闵行区自然科学研究课题(2018MHZ024)

摘　　要：目的:研究超微血管显像(superb microvascular imaging,SMI)与超声造影(contrast-enhanced ultrasound,CEUS)在膀胱占位性病变中的临床诊断价值。方法:对25例患者行常规膀胱超声检查,发现占位性病变者行彩色多普勒血流显像(color Doppler flow imaging,CDFI)、SMI及CEUS检查,比较3种技术在膀胱占位性病变中血流显示的差异,并观察造影剂进入病灶的灌注模式,分析其灌注特点,最后与手术后病理学检查结果进行对照分析。结果:25例膀胱占位性病变患者共36个病灶,其中膀胱恶性肿瘤31个、膀胱内翻性乳头状瘤2个、腺性膀胱炎3个。SMI与CEUS对膀胱占位性病变的血流显示率为100%,明显高于CDFI(69.4%),差异有统计学意义(P<0.05)。CEUS提示恶性病灶35个,造影表现为快进慢退高增强;腺性膀胱炎1个,造影表现为慢进同退等增强。CEUS的诊断准确率为88.9%。结论:SMI与CEUS均能提高膀胱占位性病变的血流显示率。CEUS能实时观察膀胱占位性病变的血流情况,有助于判断其性质,具有较高的良恶性鉴别诊断价值。Objective:To study the clinical value of superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS)in the diagnosis of bladder occupied lesions.Methods:A total of 25 cases with bladder occupied lesions found by conventional ultrasound were examined by color Doppler flow imaging(CDFI),SMI and CEUS.The differences in displaying blood flow of bladder occupied lesions among the three methods were analyzed,and the perfusion pattern of CEUS was investigated.Results:Among 36 bladder occupied lesions,31 were malignant,2 were inverted papilloma of the bladder,and 3 were glandular cystitis.The blood flow displaying rates of SMI and CEUS were 100%,which were significantly higher than that of CDFI(69.4%)(P<0.05).Thirty-five malignant lesions were diagnosed by CEUS,showing fast enhancement,delayed washout and hyperenhancement.One glandular cystitis case showed slow enhancement,isochronous washout and iso-enhancement.The diagnostic accuracy of CEUS was 88.9%.Conclusion:Both SMI and CEUS can increase the displaying rate of blood flow of bladder occupied lesions.CEUS can real-time display the blood flow,which is helpful in differential diagnosis of benign bladder occupied lesions from malignant ones.

关 键 词：超微血管显像 超声造影 膀胱占位性病变 

分 类 号：R737.14[医药卫生—肿瘤]