肝肿瘤实时超声造影研究

目的 探讨实时超声造影在肝肿瘤诊断中的价值。方法 对30例共35个肝内占位性病变进行实时谱波超声造影检查，其中16个原发性肝癌，4个转移性肝癌，9个肝血管瘤，5个局灶性结节性增生，及1个硬化结节，选用百胜Megas超声诊断仪（机械指数0.04-0.06)和Bracco公司的SonoVue超声造影剂。结果 经超声造影后，35个病灶均有不同程度的增强，其实时增强方式有整体性，周边型、及中央型三种；造影增强至峰值时的病灶表现有均状、环状及不均性增强。肝癌以整体型和不均状为主；肝血管瘤以周边型和环状增强为主；局灶性结节性增生以中央型和均状增强为主。结论 实时超声造影能反映不同肝肿瘤的血流动力学改变，可帮助提高肝肿瘤的超声诊断的准确性。

Real-time contrast ultrasonography of focal liver lesions

Purpose To evaluate the value of real - time contrast-enhanced ultrasonograpgy in hepatic tumors. Methods Thirty patients with 35 hepatic solid lesions were examined by real - time contrast - enhanced ultrasonography, including 16 primary liver malignant tumors, 4 metastatic liver tumors, 5 focal nodular hyperplasias, 9 hemangiomas and 1 cirrhotic nodule. All cases were confirmed by histopathology. The ultrasound unit (Esaote Megas) with real-time contrast-enhanced technique was used. The contrast agent used was SonoVue (Bracco, Italy). Results After injection of SonoVue, all lesions were enhanced on real-time ultrasonogram. Three patterns of enhancement were observed according to dynamic enhanced model: holistic enhanced pattern, peripheral enhanced pattern, and central enhanced pattern. The homogeneous enhanced pattern, rim- like enhanced pattern and inhomogeneous enhanced pattern in the hepatic tumors were shown at the peak volume of enhancement. The holistic and inhomogeneous enhancements were mosdy shown in primary malignant tumors, the peripheral and rim - like enhancements were mostly shown in hemangiomas, and the central and homogeneous enhancements were mostly shown in focal nodular hyperplasias. Conclusion The hemodynamic changes in various hepatic lesions will be reflected by real - time contrast - enhanced ultrasonograph and the accuracy in the diagnosis of liver tumors will be improved.