肝脏肿瘤的彩色多普勒血流显像及频谱形态分析

目的探讨肝脏肿瘤的彩色多普勒血流分布及多普勒血流频谱形态特点，以提高超声对肝脏良恶性肿瘤的诊断符合率。 方法对76例肝脏良恶性肿瘤进行彩色多普勒超声检测，检测结果与其病理或CT、MRI进行对照分析。 结果（1）原发性肝癌、肝腺瘤彩色多普勒血流常出现于肿瘤中央部位，而转移性肝癌和肝血管瘤彩色多普勒血流常出现于肿瘤周边部位；（2）原发性肝癌和转移性肝癌多普勒血流频谱形态常表现为：收缩期峰值速度前移，常出现于收缩期的前三分之一时段，收缩期上升及下降速度均较快，表现为上升波和下降波陡直，舒张期起始波常出现于收缩期下降波的中点以下，舒张末期常无血流或出现反向血流频谱；肝腺瘤和肝血管瘤多普勒血流频谱形态常表现为：收缩期峰值速度常居中，出现于收缩期的中三分之一时段，收缩期上升及下降速度均较慢，表现为上升波和下降波倾斜，舒张期起始波常出现于收缩期下降波的中点以上，舒张末期常出现血流频谱。 结论彩色多普勒血流分布特点及其多普勒血流频谱形态特征是鉴别肝脏良恶性肿瘤值得重视的指标。

Evaluation of Color Doppler Flow Imaging and Doppler Spectra in Liver Tumors

Objective To evaluate color Doppler flow imaging(CDFI) and Doppler spectra in the differential diagnosis of liver tumors.Methods Seventy-six cases with liver tumors underwent color Doppler ultrasonography (CDUS) in comparison with their pathological or CT or MRI results.Results (1)In the group of primary liver carcinoma and hepatic adenoma,color blood flows were often detected within the central area of focal hepatic lesions,but in the group of matastatic liver carcinoma and hepatic hemangioma,color blood flows were often detected within the peripheral area of focal hepatic lesions;(2)In the group of primary liver carcinoma and liver metastatic carcinoma,the anterior 1/3 of the systolic peak wave appeared ante-shift,and the velocity of the ascending and descending branches of the systolic was very sharply and quickly.The biginming of the diastolic wave appeared below the middle point of the systolic descending branch and no blood flow or reversed flow was in the latest diastolic wave.In the group of hepatic adenoma and hepatic hemangioma,the peak systolic wave was often appeared normal and the velocity of the ascending and descending branches was very slowly.The beginning of the diastolic wave often appeared above the middle point of the systolic descanding branch.The latest diastolic wave often appeared.Conclusions CDFI and Doppler spectra are important inclices for differential diagnosis of liver tumors.