超声造影检查在肝占位性病变诊断中的应用价值

背景:随着超声造影剂及其成像技术的迅速发展,超声造影技术的临床应用日趋成熟,为肝占位性病变的诊断提供了新手段.目的:分析各种不同的肝占位病变在超声造影检查中的表现,探讨其对该类疾病的诊断价值.方法:使用SonoVue造影剂对22例不同类型的肝占位性病变进行超声造影检查,同时以视频影像同步记录造影剂进入肝内血管、肝实质和肝占位性病变的时间和形态的变化.结果:不同类型的肝占位性病变在超声造影检查中显示出不同的动脉相、门静脉相和延迟相的变化.原发性肝癌以造影剂"快进快出"为主要表现;转移性肝癌以延迟相造影剂充盈缺损为主要表现;肝血管瘤以延迟相有显著的造影剂摄取为主要表现;肝脓肿以快速增强持续整个门静脉相和延迟相为主要表现;肝硬化结节则以与肝实质无法区分的同步强化为主要表现.结论:超声造影检查对肝占位性病变的定性诊断明显优于普通超声检查,在显示肿瘤数目,尤其是发现微小病灶方面优于增强CT,提高了超声检查对肝占位性病变的诊断价值.

Practical Value of Contrast-enhanced Ultrasound in Diagnosing Focal Hepatic Lesions

Background: With the rapid development of contrast agents and ultrasound imaging technique, ultrasonography is now a mature technique. Its clinical use provides a new method for the diagnosis and differential diagnosis of focal hepatic lesions. Aims: To analyze various features of focal hepatic lesions in contrast-enhanced ultrasonography and to appraise its diagnostic. Methods: A total of 22 patients with different kinds of focal hepatic lesions were examined by contrast-enhanced ultrasonography using SoneVue as the contrast agent and recorded with video CD. Results: Different features were shown during the arterial phase, portal venous phase and lag phase, which were important for the diagnosis and differential diagnosis of focal hepatic lesions. Primary hepatocelluar cancer had the characteristics of "rapid-in and rapid-out", metastatic liver cancer presented areas of "filling defect" during the lag phase, hemangiomas had an increased uptake of contrast agent at the portal venous phase and lag phase, liver abscess showed immediate enhancement and kept until the lag phase, while the enhancement of cirrhotic nodule was of the same intensity as the liver parenchyma. Conclusions: This new contrast-enhanced ultrasonography is significantly superior to conventional ultrasonography in the diagnosis of liver neoplasm and also significantly superior to contrast CT in detecting minute lesions, thus it greatly improves the diagnostic value of ultrasonography in liver neoplasms.