超声造影在肝、胆疾患的诊断及微创治疗疗效评价中的应用价值

目的：探讨超声造影技术在肝、胆疾患的诊断及微创治疗疗效评价中的应用价值。材料与方法：对300例肝内实性病灶、33例胆囊占位性性病变、28例肝肿瘤微创治疗术后进行超声造影检查，了解病变的微循环血流灌注模式，评估病变的性质，评判其灭活的情况，对灭活不完全的病灶进行准确定位，提高补充治疗的准确性。所有病例都经手术穿刺活检得到病理诊断。结果：20例肝细胞癌增强方式表现为：“快进快出”及无增强两种；6例转移癌均表现为：厚环状“快进快出”；9例肝脓肿表现为：厚壁环状蜂窝状增强和整体高增强且显示的病灶区域明显大于灰阶显像异常回声区；2例肝炎性病灶均表现为：动脉期快速整体增强，门脉期部分区域快速减退呈低增强；20例非均质脂肪表现为：三个时期与肝实质同步增强；239例肝血管瘤表现为：周边呈环状结节样向心性增强、整体增强和周边呈环状增强3种；33例胆囊胆固醇型息肉表现为：蜂窝样增强和整体增强2种；4例胆泥表现为：三个时期均无增强；28例肝肿瘤术后疗效评价：20个病灶完全灭活，在造影各时期均未见增强，呈“黑洞”，8个病灶局部强，经补充治疗后，病灶完全灭活。结论：超声造影技术是诊断肝胆疾患的有效方法，对疾病的性质判断明显高于二维超声检查；是肿瘤微创治疗后疗效评价的有效方法，也为残存病灶补充治疗的准确定位提供了重要的依据。

Ultrasound Imaging Technology in the Diagnosis of Liver,Gallbladder Disease of Application Value and in the Evaluation of Curative Effect of Minimally Invasive Treatment

Purpose： To discuss the application value of ultrasound imaging technology in the diagnosis of liver, gall- bladder disease and in the evaluation of curative effect of minimally invasive treatment. Materials and Methods： To 300 ca- ses of intrahepatic solid venereal stove, 33 cases of gallbladder space-occupying lesions, 28 cases of liver tumor minimally in- vasive treatment of postoperative on contrast-enhanced ultrasound examination, understand the pathological changes of micro- circulation perfusion pattern, the nature of the assessment of lesions, judge the inactivated, lesions of inactivated not complete- ly accurate positioning, improve the accuracy of complementary medicine. All cases by surgical biopsy for pathological diagno- sis. Results： To 20 cases of hepatocellular carcinoma （HCC） enhancement pattern characterized by： ＂fast forward quick- ly＂, and not enhance two ; 6 cases of metastatic carcinoma were as follows ： thick circular ＂fast into fast out＂ ; 9 cases of liver abscess is shown as： thick wall circular honeycomb enhancement and overall high enhancement and display the lesion area sig- nificantly greater than gray-scale imaging abnormalities echo area; 2 cases of livers inflammatory lesions were as follows： rapid overall arterial enhancement and portal phase of the area of the rapid decrease in low enhancement; 20 cases of inhomogeneous fat is shown as ： three time synchronization with the liver parenchyma enhancement ; Around 239 cases of liver hemangioma is shown as： show cricoid nodular centripetal enhancement, the overall enhancement and enhanced images show cricoid around three ; Type of 33 cases of gallbladder cholesterol polyps are： honeycomb-like enhancement and the overall enhancement; 4 ca- ses of bile mud performance is ： the three periods are not enhance ; 28 cases after liver tumor curative effect evaluation ： 20 dis-ease Stove completely inactivated, in different period are not seen to enhance imaging, a ＂black hole＂, eight lesions locally Strong, after supplementation, lesions completely inactivated. Conclusion： contrast-enhanced ultrasound technique is an ef- fective method for diagnosis of liver diseases, determine the nature of disease is significantly higher than two-dimensional ultra- sound ; Is an effective method of tumor after minimally invasive treatment curative effect evaluation, as well as residual lesions supplementation of accurate positioning provides an important basis.