超声造影在门脉癌栓诊断和分型中的临床价值

目的: 通过与增强CT对比,探讨超声造影在门脉癌栓(PVTT)诊断和分型中的临床应用价值。方法: 选取43例经临床和病理证实的PVTT患者,对比分析超声造影和增强CT对PVTT的诊断准确率及临床分型准确率。结果: PVTT超声造影表现为"快进快出"的特征,88.4%(38/43)癌栓的动脉相表现为高增强,81.4%(35/43)癌栓的门脉相表现为低增强,所有癌栓的延迟相均表现为低增强。超声造影诊断门脉癌栓的准确率为100%,增强CT为97.7%(42/43);超声造影分型准确率为95.3%(41/43),增强CT分型准确率为93.0%(40/43);2种方法比较差异无统计学意义(P>0.05)。结论: 超声造影可以动态显示PVTT的血流灌注特征并显示癌栓的实际浸润范围,超声造影和增强CT在PVTT的定性诊断和临床分型方面有很好的一致性,超声造影可作为PVTT治疗前评估的重要影像学方式。

Clinical values of contrast-enhanced ultrasound in diagnosis and classification of portal vein tumor thrombosis

Objective:To explore the clinical application values of contrast-enhanced ultrasound in the diagnosis and classification of portal vein tumor thrombosis (PVTT)by comparing with enhanced CT.Methods:43 patients with PVTT confirmed by clinic and pathology were selected, and the accuracy rates of the diagnosis and clinic classification of contrast-enhanced ultrasound and enhanced CT were compared. Results:The characteristic of PVTT in contrast-enhanced ultrasound was“quick in fast out”;88.4% (38/43)of PVTT were hyper-enhancement in the arterial phase, 81.4% (35/43 ) of PVTT were hypo-enhancement in the vein phase, and all tumor thrombosis showed hypo-enhancement in the delay phase. The diagnostic accuracy rate of contrast-enhanced ultrasound in PVTT was 100%,and the accuracy rate of enhanced CT was 97.7% (42/43).The classification accuracy rate of contrast-enhanced ultrasonic was 95.3% (41/43),and the accuracy rate of enhanced CT was 93.0% (40/43 );there was no statistically significant difference between two methods (P > 0.05 ). Conclusion:Dynamiccontrast-enhanced ultrasonography can display the blood perfusion characteristics of PVTT, and displays the actual infiltrating tumor thrombosis. Ultrasonic imaging and enhanced CT in the qualitative diagnosis of PVTT and clinical classification have a good consistency.Contrast-enhanced ultrasound can be used as an important imaging method to evaluate the PVTT before treatment.