超声造影与彩色多普勒诊断肝肿瘤的临床应用

目的比较实时超声造影和彩色多普勒超声在肝肿瘤诊断中的临床应用价值。方法应用超声造影技术及彩色多普勒超声对常规二维超声难以定性的30例患者31个肝占位灶进行检查，并与病理结果相对照。结果31个病灶中肝恶性肿瘤24个，肝血管瘤3个，肝硬化增生结节1个，肝脓肿2个，肝包虫1个。除1例肝包虫外，其余30个病灶超声造影均在不同时相出现不同程度强化现象。彩色多普勒超声在病灶内部或周边能检测到动脉血流频谱者共19例20个病灶；以增强早期呈高回声而增强晚期呈低回声为恶性肿块的诊断标准，则超声造影对肝癌诊断的准确性为93％；以病灶内部检测到动脉样血流频谱为诊断恶性肿块的诊断标准，则彩色多普勒超声诊断肝恶性肿瘤的准确性为74％，二者差别有统计学意义（P〈0．05）。结论实时超声造影能提高肝肿瘤诊断的准确性，对肝肿瘤良、恶性的诊断及鉴别诊断具有重要的临床应用价值。

Comparison of Differential Diagnosis of Hepatic Tumors on Contrast-enhanced Ultrasound and Colour Doppler

Objective To compare the differential diagnostic value between contrast-enhanced ultrasound （CEUS） and color Doppler uhrasonography （CDUS） in liver tumors. Methods CEUS and CDUS were applied to 30 patients with 31 hepatic lesions. Results All the lesions were confirmed by pathology, including 24 hepatic malignant tumors, 3 hepatic hemangiomas, 1 cirrhosisnodularity, 2 hepatic abscesses and 1 hepatic echinococcosis. The arterial blood flow could be detected via CDUS in 19 patients （20 hepatic lesions）. If the hepatic lesions showed the enhancement in earlier phase and rapid wash-out in delayed phases on CEUS and showed arterial blood flow in or around the lesions on CDUS they were regarded as malignant tumors. The accuracy of the two methods in the diagnosis of hepatic malignant tumors was 93 % and 74% （P 〈 0.05 ） , respectively. Conclusion Compared to CDUS, CEUS can raise the accuracy in the diagnosis of hepatic malignant tumors and is a useful technique in the differential diagnosis of benign and malignant hepatic tumors.