Sonazoid及SonoVue超声造影下肝局灶性病变的灌注模式探讨及与增强MRI的比较研究  

Contrast-enhanced ultrasound perfusion patterns of hepatic lesions using Sonazoid or SonoVue as contrast agents and comparative study with enhanced MRI

作　　者：韩红 丁红 黄备建 毛丽娟 方超[3] 王文平 HAN Hong;DING Hong;HUANG Beijian;MAO Lijuan;FANG Chao;WANG Wenping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Institute of Medical Imaging,Shanghai 200032,China;Department of Ultrasound,The Central Hospital of Xuhui District,Shanghai 200031,China)

机构地区：[1]复旦大学附属中山医院超声科,上海200032 [2]上海市影像医学研究所,上海200032 [3]上海市徐汇区中心医院超声科,上海200031

出　　处：《肿瘤影像学》2020年第6期559-564,共6页Oncoradiology

基　　金：上海市自然科学基金(19ZR1450700)。

摘　　要：目的:评价在示卓安(Sonazoid)及声诺维(SonoVue)两种不同超声造影剂下肝局灶性病变灌注模式异同,并与增强磁共振成像(magnetic resonance imaging,MRI)进行比较。方法:25例肝局灶性占位患者,随机接受SonoVue或Sonazoid超声造影,患者均进行增强MRI检查。观察肝内良恶性病灶在不同增强检查方式、不同超声造影剂下灌注模式的异同。结果:25例肝局灶性占位中恶性肿瘤11例,良性肿瘤14例。超声造影与增强MRI在评价肝局灶性占位的动脉期增强与延迟期廓清上差异无统计学意义(P=1.00,P=0.50)。2例恶性病灶,超声造影显示延迟期廓清,但增强MRI显示延迟期为等信号及环形增强。与SonoVue超声造影相比,Sonazoid超声造影时肝实质延迟期造影剂浓度高,观察病灶廓清时间更充分。结论:应用SonoVue或Sonazoid超声造影和增强MRI均可用于肝内局灶性占位的诊断与鉴别,恶性病灶多表现为“动脉期增强、延迟期廓清”的血流动力学特点。在少部分患者中,超声造影、增强MRI两种影像学检查方法在延迟期存在差异。两者互相补充,可进一步提高肝内占位性病变的诊断准确性。Objective:To evaluate the similarities and differences in perfusion patterns of focal liver lesions when Sonazoid or SonoVue was used as contrast agents during contrast-enhanced ultrasound,and to further compare the similarities and differences between contrast-enhanced ultrasound and enhanced magnetic resonance imaging(MRI).Methods:Twenty-five patients with hepatic tumors were all examined with contrast-enhanced ultrasound and enhanced MRI.The contrast agent was randomly used with SonoVue or Sonazoid.The difference of perfusion pattern between benign and malignant intrahepatic lesions in different enhanced examinations and different contrast agents were analyzed.Results:Among the 25 cases,there were 11 cases of malignant tumor and 14 cases of benign tumor.There was no significant difference between contrast-enhanced ultrasound and enhanced MRI in evaluating the arterial phase enhancement and contrast agent clearance in the delayed phase in hepatic tumors,P=1.00 and P=0.50 respectively.In 2 cases of malignant lesions,contrast-enhanced ultrasound showed contrast agent clearance in delayed phase,but enhanced MRI showed equal signal intensity and circular enhancement in the delayed phase.Compared with SonoVue,the use of Sonazoid as contrast agent showed a higher echogenicity of the liver parenchyma and more pronounced clearance of the liver lesions in the delayed phase.Conclusion:Both contrast-enhanced ultrasound applying SonoVue or Sonazoid as contrast agents and enhanced MRI can be used for the differential diagnosis of liver lesions, and malignant lesions mostly show hemodynamic characteristics of “arterialphase enhancement and delayed phase clearance”. In a few cases, there may be differences in the portal and delayed phases betweenthe two imaging methods. Contrast-enhanced ultrasound and enhanced MRI can be used as complementary examinations, and theircombined application can further improve the diagnostic accuracy of hepatic tumors.

关 键 词：肝占位 超声造影 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]