肝癌及门静脉癌栓血供灌注特征的彩超与超声造影研究

目的探讨彩超(CDUS)与超声造影(CEUS)对不同类型肝癌及门静脉癌栓(PVTT)的血供灌注特征及临床价值。方法应用CDUS及CEUS对经临床证实的369例437个不同类型肝癌病灶及合并的PVTT进行血供灌注特征和血流动力学变化的研究分析。结果①肝癌血供灌注呈多样性:肝动脉血供为主型占72.8%(318/437),肝动脉和门静脉双重血供型占16.7%(73/437),肝动脉和门静脉双重血供兼动静脉瘘型占8.2%(36/437),门静脉血供为主型占2.3%(10/437)。②PVTT血供灌注也呈多样性,即肝动脉血供型或双重血供型。③肝癌血供的CEUS初始强化形态与肿瘤血管分布状态密切相关。结论 CEUS可明确判定肝癌及合并的PVTT的血供灌注特征,对肝癌的诊断、鉴别诊断及治疗方案的选择有重要的临床价值。

Clinical study of blood perfusion characteristics in liver cancer and portal vein tumor thrombosis by CEUS and CDUS

Objective To study the blood perfusion characteristics of different kinds of liver cancer lesions and portal vein tumor thrombosis（PVTT） by color Doppler ultrasound（CDUS） and contrast-enhanced ultrasound（CEUS）.Methods The blood perfusion characteristics and hemodynamics change of 437 leisons in 369 patients with liver cancer and included PVTT comfirmed by clinical data were analyzed by CEUS and CDUS.Results The blood perfusion characteristics of liver cancer lesions were varied： ①72.8%（318/437） were mainly hepatic artery type;16.7%（73/437） were hepatic artery and portal vein blood supply type;8.2%（36/437） were hepatic artery and portal vein blood supply combined arteriovenous fistula type;2.3%（10/437） were mainly portal vein type.②The blood perfusion characteristics of PVTT were hepatic artery or double blood supply type.③The initial enhanced shape of CEUS was closely correlated with vascular distribution of tumor.Conclusion CEUS can identify the blood perfusion characteristics of liver cancer and PVTT,which be valuable to diagnosis and treatment of liver cancer.