超声造影定量参数对眼眶肌锥外间隙良恶性肿瘤的鉴别价值  

The value of contrast-enhanced ultrasonography in differential diagnosis of orbit tumors in extraconal compartment

作　　者：张瑶 陈文卫[1] 胡伟[1] 孙彬[1] 邓倾[1] 黄鑫[1] 黄星月[1] 张隽 王尚 Zhang Yao;Chen Wenwei;Hu Wei;Sun Bin;Deng Qing;Huang Xin;Huang Xingyue;Zhang Jun;Wang Shang(Department of Ultrasound,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2019年第9期798-802,共5页Chinese Journal of Ultrasonography

摘　　要：目的通过分析超声造影相关参数,为眼眶肌锥外间隙肿瘤鉴别诊断提供量化依据。方法回顾分析经超声造影检查的眼眶肌锥外间隙肿瘤患者76例,应用SonoLiver造影软件分析超声造影图像,获取时间-强度曲线(TIC)、动态血管模式曲线(DVPC)及相关参数。根据病理结果将患者分为两组:恶性组27例,良性组49例。分析两组间DVPC、TIC曲线特点,比较两组病灶区的到达时间(AT)、上升时间(RT)、达峰时间(TTP)、峰值强度(IMAX)、平均渡越时间(mTT)、上升支斜率(K1)及半降斜率绝对值(K2)等指标并行ROC曲线分析获取鉴别诊断的最佳截断值。结果①良性肿瘤TIC主要表现为快升慢降波,DVPC主要表现为正向波;恶性肿瘤TIC主要表现为快升快降波,DVPC主要表现为正负双向波。②两组TIC定量参数IMAX、K1、K2、mTT、RT差异均具有统计学意义(P<0.05),而AT、TTP差异无统计学意义(P>0.05)。③IMAX为456.2%、K1为109.6、K2为35.2、RT为7.9s、mTT为28.1s是鉴别眼眶肌锥外间隙良恶性肿瘤的最佳截断值,其中以mTT为28.1s鉴别诊断价值最高(敏感性81%,特异性77%)。结论超声造影量化分析可为眼眶肌锥外间隙良恶性肿瘤的鉴别提供量化依据,具有较高临床价值。Objective To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast-enhanced ultrasonography (CEUS). Methods A total of 76 patients with orbit tumors in extraconal compartment who underwent CEUS examination were retrospectively analyzed. These patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor. CEUS images were analyzed using Sonoliver software. The time-intensity curve (TIC) and dynamic vascular pattern curve (DVPC) were acquired and the characteristics of the arterial flow infusion of these were analyzed. The related parameters such as time of arrival time(AT), rise time (RT), time to peak(TTP), mean transit time(mTT), slope of rise(K1), the absolute value for slope of down (K2) were also obtained. The differences of DVPC, TIC and quantitative parameters between the two groups were compared. Receiver operating curve analysis was used to acquire the cut-off values of these parameters for differential diagnosis. Results ①TICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic, while TICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic.②The differences of quantitative parameters IMAX, K1, K2, mTT and RT of TICs were statistically significant between the two groups (P<0.05), while those of AT and TTP were not (P>0.05).③IMAX=456.2%, K1=109.6, K2=35.2, RT=7.9 s, mTT=28.1 s were the best cut-off values for differential diagnosis. Among these parameters, mTT with 28.1 s had the highest diagnostic value(sensitivity: 81%, specificity: 77%). Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment.

关 键 词：超声造影 眼眶肌锥外间隙肿瘤 时间强度曲线 动态血管模式 

分 类 号：R739.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]