利声显静脉声学造影反向脉冲肝灰阶增强成像提高肝肿瘤检出的应用研究  

Application of the pulse inversion grayscale imaging with levovist contrast echo to increased the detection rate of hepatic tumor

作　　者：莫国强[1] 刘学明[1] 潘敏强[1] 陈伟[1] 张闻[1] 许俊[1] 

机构地区：[1]浙江大学医学院附属二院超声科,杭州310009

出　　处：《中华超声影像学杂志》2002年第11期661-664,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨声学造影反向脉冲灰阶增强与血流成像在肝肿瘤检出中的应用。方法　 35例肝肿瘤 ,手术治疗 2 3例 ,射频治疗 5例 ,7例广泛转移及多病灶而未行创伤性治疗。采用Levovist 2 .5g ,稀释至 7ml,经肘静脉微泵连续静脉注射 ,2ml/min,低机械指数 (MI0 .4)观察血流成像 ,高机械指数 (MI 1 .3)灰阶增强成像 ,间歇手控 ,间隔时间 1 0～ 2 0s。结果　 1 4例转移性肝癌中 1 2例肿瘤边缘肝组织回声明显增强 ,8例肿块内回声无增强 ,表现为低回声 ,与造影灰阶增强前对照 3例发现新病灶 ,最小病灶 3mm左右 ;1 8例原发性肝癌周围肝组织回声增强表现多样化 ,1 6例肿瘤内回声不均匀增强 ,4例发现新病灶 ,血流成像发现转移性肝癌与原发性肝癌明显不同 ;另 3例 (结节性增生伴癌变、血管平滑肌脂肪瘤恶变、肝腺瘤 )均显示丰富的造影剂信号。结论　经静脉声学造影反向脉冲灰阶增强成像可提高肿瘤的检出 。Objective To assess the evaluation of the pulse inversion imaging with levovist in hepatic tumor. Methods Thirty five cases with hepatic tumor were examined with pluse inversion imaging, levovist was injected intravenously by a microinfusion pump in a 2.5 g dose at a concentration of 357 mg/ml, with a 7 ml normal saline flush, by using 2 ml/min. Flow imaging was shown at low MI( 0.4 ), blood vessels were uniformly bright. Grayscale imaging of the liver parenchyma was performed at high MI( 1.3 ) with an interval duration about 10～20 seconds. Results Of the 14 cases with metastatic tumors,12 cases revealed marked enhanced echo of liver parenchyma adjacent to tumor,8 cases displayed no enhancement in intratumoral echo and hypoechoic appearance, comparing with before contrast enhancment, new lesions were found in 3 cases, the smallest lesions were 3 mm in size.The enhanced echo of liver parenchyma adjacent to the carcinoma showed varieties in 18 cases of hepatocellular carcinoma, and enhancement of the intratumoral echo showed heterogeneous in 16 cases, new lesions were detected in 4 cases.The metastatic tumors were significantly different from primary hepatic tumor in the morphologic characteristic of these tumor vessels with pulse inversion imaging of blood flow. Another 3 cases,the nodular hyperplasia and angioleiomyliporma with carceration, hepatic adenoma revealed significant contrast echo. Conclusions Intravenous injection of ultrasound contrast agent and pulse inversion grayscale imaging could increase the detection of hepatic tumor. Flow imaging has an important value to differentiate the primary liver cancer from metastases lesions.

关 键 词：静脉声学造影 反向脉冲肝灰阶增强成像 肝肿瘤 诊断 

分 类 号：R735.7[医药卫生—肿瘤] R730.[医药卫生—临床医学]