实时灰阶谐波超声造影在肝肿瘤中的应用

目的 研究实时灰阶谐波超声造影在肝肿瘤诊断中的价值。方法 对89例共101个肝内占位病灶进行实时灰阶谐波超声造影检查，其中原发性肝癌36例38个病灶，转移性肝癌24例32个病灶，肝血管瘤16例18个病灶，肝脓肿2例，硬化结节5例，局灶性结节性增生2例，肝腺瘤1例，局灶性脂肪肝3例。选用低机械指数成像技术GE Logiq 9超声诊断仪和Bracco公司的SonoVue超声造影剂。结果 注入造影剂后，实时谐波超声造影能显示不同肝肿瘤的造影特点，并能显示肿瘤的血流灌注信号。超声造影正确诊断肝癌和肝良性肿瘤病灶分别为67个（/70）和29个（/31）。其诊断肝癌的敏感性、特异性及准确性分别为95.7%、93.5%、95%。结论 实时灰阶谐波超声造影能反映不同肝肿瘤增强模式及血流动力学变化，可帮助提高肝肿瘤超声诊断的准确性。

Real-time Gray Scale Harmonic Contrast-enhanced Ultrasound in the Diagnosis of Hepatic tumors

abstract] Objective To evaluate the value of real-time gray scale harmonic contrast-enhanced ultrasound in the diagnosis of hepatic tumor.methods Eighty-nine patients with 101 hepatic lesions were examined by using real-time gray scale harmonic contrast-enhanced ultrasound(Real-time HCEUS) , including 36 primary liver carcinoma (PLC) with 38 lesions, 24 metastatic liver carcinoma（MLC）with 32 lesions，16 hepatic cavernous hemangioma(HCH) with 18 lesions,2 hepatic abscess, 5 cirrhotic nodule, 2 focal nodular hyperplasia（FNH）, 1 hepatic adenoma and 3 focal fatty change.All cases confirmed by pathology or CT. The ultrasound apparatus (GE Logiq 9) with low-mechanical index(MI) contrast enhanced technique was used. The contrast agent used was SonoVue (Bracco, Italy).Results The various enhanced specific signs and perfusion signals after injection of SonoVue were displayed with real-time gray scale HCEUS in the hepatic lesions. 67(/70) hepatic cancer and 29(/31) benign liver tumor were diagnosed exactly by contrast-enhanced ultrasound.The sensitivity, specificity and accuracy in the diagnosis of liver cancer with real-time gray scale HCEUS were 95.7%,93.5% and 95% respectively.conclusions The dynamic enhanced fashions and various enhanced features in various hepatic tumors will be reflected by real time gray scale HCEUS,which improves the accuracy of ultrasonography in the diagnosis of liver tumors.