低声压实时超声造影技术对体积较小肝癌的诊断价值

目的探讨低声压超声造影诊断体积较小肝癌的价值。方法使用造影剂SonoVue检查小肝癌249例共267个病灶（最大直径≤3cm），包括原发性肝癌218个，转移性肝癌49个。分析病灶的增强方式和增强时相。结果多数小肝癌动脉期增强、门脉期消退，原发性和转移性肝癌间增强时相无差异。增强达峰时原发性肝癌以整体增强为主，而转移性肝癌中环状增强的比例明显高于原发性肝癌，两者差异显著。若结合增强方式和时相，本组鉴别诊断肝细胞性肝癌的敏感性为98．1％。结论超声造影可实时显示小肝癌相对于肝实质增强和消退的动态过程，获得病灶内微血管的影像，从而敏感地鉴别诊断肝癌。

Value of contrast-enhanced ultrasonography with low acoustic power in the diagnosis of small hepatic malignancies

Purpose To investigate the value of real-time contrast-enhanced ultrasonography in the diagnosis of small hepatic malignancies. Methods SonoVue-enhanced ultrasonography was performed on 249 cases with 267 hepatic malignancies(smaller than 3cm in diameter),including 218 primary liver carcinomas(PLC) and 49 metastases.Enhancement patterns and phases of hepatic lesions on ultrasonography were analyzed retrospectively. Results Most hepatic malignancies enhanced early in the arterial phase and wash-out in portal phase.There was no difference between PLCs and metastases.The most common enhancement pattern in PLCs was whole-lesion enhancement,while whole-lesion enhancement and rim-like enhancement were both frequent in metastases.The presence of rim-like enhancement in metastases was significantly higher than that in PLCs.When combined the enhancement phases and patterns on ultrasonography,the sensitivity for differentiating hepatocellular carcinoma was 98.1%. Conclusions Contrast-enhanced ultrasonography displays real-timely dynamic enhancement as well as its wash-out in hepatic lesions and parenchyma.Based on the microvascular images on ultrasonography,hepatic malignancies can be sensitively differentiated.