肝脏局灶性病变的实时三维超声造影成像质量的影响因素分析

目的探讨实时三维超声造影（4D-CEUS）成像质量的影响因素。 方法回顾性分析2013年6月至2014年3月经病理及临床确诊的151例肝脏局灶性病变（FLLs）患者的影像资料，对其4D-CEUS成像质量进行评分并分析影响成像质量的因素。 结果（1）4D-CEUS检查时慢推造影剂组得到的纯动脉相最长，平均时间为（5.17±1.03）s，成像质量优于常规团助法（统计值88.868，P=0.000）。（2）151例FLLs的4D-CEUS动脉期成像质量评价1级82例（54.3%），2级17例（11.3%），3级25例（16.6%），4级27例（17.9%）。151例病变呈高、等、低或无增强者分别有119例（78.8%）、6例（4.0%）和26例（17.2%）。病变直径、位置、扫查路径、有无干扰因素、有无伪影、动脉期增强程度对4D-CEUS的成像质量有显著影响（统计值为-2.455、-2.198、-2.428、-5.575、-6.469、43.060，均P<0.05）。 结论4D-CEUS成像质量的影响因素有注药方式，病变直径、位置及增强方式，扫查路径、扫查过程中有无伪影，有无膈肌、肋骨、心脏、大血管等成像干扰因素。

Image quality of dynamic three-dimensional contrast-enhanced ultrasonography in focal liver lesions:an analysis of influencing factors

ObjectiveTo explore 4D-CEUS methodologies and the factors affecting image quality. Methods4D-CEUS data of one hundred and fifty-one focal liver confirmed by pathology and clinical follow-up from the First Affiliated Hospital of Sun Yat-sen University were respectively analyzed. The image quality was scored and influencing factors were analyzed. Results(1) The injection methods of 4D-CEUS had significant influence on the imaging quality of 4D-CEUS, while slow injecting contrast agents without saline could prolong pure arterial pulse, mean time was (5.17±1.03) s, with image quality superior to conventional bolus (statistical value 88.868, P=0.000). (2) The image quality of 4D-CEUS in the arterial phase of 151 FLLs was divided into 4 grades, with 82 cases (54.3%) in grade 1, 17 cases (11.3%)in grade 2, 25 cases (16.6%) in grade 3, 27 cases (17.9%) in grade 4. The number of lesions showing hyper-enhancement, iso-enhancement, hypo-enhancement was 119 (78.8%), 6 (4.0%) and 26 (17.2%), respectively. Location of lesions, sizes, scanning path, interference, and the artifacts had significant influences on the image quality of 4D-CEUS (statistical values -2.455, -2.198, -2.428, -5.575, -6.469, 43.060, all P<0.05). ConclusionThe image quality of 4D-CEUS is affected by the method of injection, sizes of lesions, location, blood supply, scanning path, the presence of artifacts, and the presence of interference.