声学造影在子宫肿瘤诊断中的应用

目的探讨新型造影剂声诺维及实时灰阶造影匹配成像技术对子宫肿瘤病变的诊断价值。方法对38例子宫肿瘤患者,采用新型造影剂声诺维及实时造影匹配成像技术进行超声造影,观察不同病变造影剂灌注过程及造影后声像图特点。结果子宫肌瘤表现为造影剂自外周向内快速充盈,假包膜强化明显,瘤体内部造影剂分布均匀,较包膜消退快,而变性区则无造影剂分布,浆膜下及黏膜下肌瘤可显示来源于子宫的蒂部供血动脉血流。宫颈癌及内膜癌病灶区滋养血管首先充盈,病灶内部强化欠均匀,消退早于正常子宫肌层。结论超声造影能清晰显示肌瘤边界及内部变性情况,能较清晰显示内膜癌及宫颈癌浸润肌层的程度,有助于提高超声对子宫肿瘤的诊断价值。

Contrast-enhanced ultrasound in the diagnosis of uterine tumors

Objective To explore the value of contrast agent (SonoVue) and real-time gray-scale contrast tuned imaging (CnTI) technology in the diagnosis of uterine tumor. Methods Thirty-eight patients with uterine tumor confirmed by pathology were studied by contrast-enhanced ultrasound with SonoVue and CnTI. The contrast agent was given in bolus intravenously. The perfusion process and the sonographic characteristics of the lesions were observed. Results The perfusion of agent was from exterior to interior and showed peripheral enhancement especially in the pseudo-capsule of uterine myoma. The myoma showed homogeneous enhancement with earlier wash-out than capsule. The degenerative area demonstrated no agent perfusion. The feeding artery from uterus depicted clearly in subserous and submucous myomas. The nutritious arteries were enhanced earliest in the cervix cancer and endometrial carcinoma. Both of the tumors were heterogeneously enhanced with earlier wash-out than uterine tissue. Conclusion Contrast-enhanced ultrasound showed clearly the boundary and interior degeneration of myoma as well as the invasive degree of endometrial carcinoma and cervical cancer, which could improve the value of ultrasound in the diagnosis of uterine tumors.