超声造影与声脉冲辐射力成像技术用于判定肝多房棘球蚴病移行带边界及活性的价值  

Value of contrast-enhanced ultrasonography and acoustic radiation force impulse elastography in identification of boundary range and viability of hepatic alveolar echinococcosis

作　　者：张玉英[1] 马钦风[1] 陈鲜霞[1] 应春花[1] 马有良[1] 黎娉[1] 高莉[1] 宋海红[1] 尹秋萍[1] ZHANG Yu-Ying;MA Qin-Feng;CHEN Xian-Xia;YING Chun-Hua;MA You-Liang;LI Ping;GAO Li;SONG Hai-Hong;YIN Qiu-Ping(Qinghai Provincial People's Hospital,Xining 810007,China)

机构地区：[1]青海省人民医院,西宁810007

出　　处：《中国血吸虫病防治杂志》2020年第1期91-93,99,共4页Chinese Journal of Schistosomiasis Control

摘　　要：目的探索超声造影与声脉冲辐射力成像技术用于判定肝多房棘球蚴病移行带边界和活性的价值。方法回顾性分析经病理证实的27例肝多房棘球蚴病患者二维超声图像和超声造影特征,并应用声脉冲辐射力成像技术测量病灶实质、病灶周边移行区和周围肝脏组织的剪切波速度。结果二维灰阶超声示肝多房棘球蚴病病灶图像显示回声不均,偏中高回声,形态不规则,边界不清,最大切面面积为(6.08±4.47)cm^2。超声造影示肝多房棘球蚴病病灶内部整个造影三期均未见造影剂充盈,呈"黑洞征",病灶周边呈环状增强,最大切面面积为(8.87±4.83)cm^2。超声造影病灶面积大于二维超声面积(t=2.20,P=0.03)。声脉冲辐射力成像技术示肝多房棘球蚴病病灶内部、边缘浸润移行带和周围正常肝组织的平均剪切波速度差异有统计学意义(F=84.538,P<0.01),病灶内部平均剪切波速度最高。结论超声造影及声脉冲辐射力成像技术能判定肝多房棘球蚴病病灶移行带边界及活力状态,对指导治疗、判定疗效和预测预后颇有价值。Objective To investigate the biologic viability and boundary range of hepatic alveolar echinococcosis(HAE)by the contrast-enhanced ultrasonography(CEUS)and acoustic radiation force impulse elastography(ARFI).Methods Totally 27 HAE patients confirmed by pathology underwent CEUS and ARFI examinations.Results Gray scale sonography of HAE showed unclear boundary,inhomogeneous,and middle hyperechoic nodules,and the maximum area was(6.08±4.47)cm^2 in 27 lesions.CEUS of HAE showed non-enhancement in three phases and black hole sign.Circumferential enhancement on the periphery of the lesion was synchronized with the liver parenchyma and showed"fast in and slow out".The maximum area was(8.87±4.83)cm^2.The area of ECUS was larger than gray scale sonography in HAE(t=2.20,P=0.03).The mean shear wave velocities(SWVs)of the interior,the boundary range,and the surrounding liver tissues of HAE were statistically different by ARFI(F=84.538,P<0.001),and the interior had the highest values.Conclusion CEUS and ARFI examinations can detect the biologic viability and boundary range of migrating zone around HAE,which is valuable for guiding treatment,judging curative effect,and predicting prognosis.

关 键 词：肝多房棘球蚴病 超声造影 声脉冲辐射力成像技术 剪切波速度 

分 类 号：R532.32[医药卫生—内科学]