超声造影与彩色多普勒超声对肝实质性肿块诊断价值

目的比较彩色多普勒超声和实时超声造影在肝实质性肿块中的诊断价值。方法应用彩色多普勒超声及超声造影技术对常规二维超声难以定性的29例患者共33个肝实质性肿块进行检查,结果与手术及病理结果相对照。结果33个肿块中原发性肝细胞性肝癌24个,肝血管瘤3个,肝脏局灶性结节增生3个,局限性脂肪肝2个,肝孤立性坏死结节1个。彩色多普勒超声在肿块内部或肿块周边能检测到动脉血流频谱者共19例21个肿块;超声造影除一例肝孤立性坏死结节外,其余32个病灶均在不同时相出现不同程度强化现象。如以动脉相呈高回声而门脉相及延迟相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92%;如以肿块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癌的准确性为75%,二者差别有显著性(P<0.05)。结论实时超声造影显著提高肝实质性肿块诊断的准确性,对肝脏实质性肿块良、恶性的诊断及鉴别诊断具有重要价值。

Differential Diagnosis of Hepatic Tumors via Contrast-enhanced Ultrasound and Colour Doppler Ultrasonography:Comparative Study

Objective To compare the differential diagnosis value of contrast-enhanced ultrasound(CEUS) and color Doppler ultrasonography(CDUS) in liver tumors.Methods Twenty-nine patients with 33 hepatic solid lesions underwent CEUS and CDUS.Results All lesions were confirmed by pathology,including 24 hepatocellular carcinomas,3 hepatic hemangiomas,3 focal nodular hyperplasia,2 focal fatty liver and 1 solitary necrotic nodule.The arterial blood flow in 21 hepatic solid lesions were detected on CDUS.Al1 hepatic solid lesions except one solitary necrotic nodule were variously enhanced in different phases after SonoVue injection.If the hepatic lesions showed the earlier enhancement in arterial phase and rapid wash-out during portal and 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 malignnt tumors were 92% and 75%(P<0.05) respectively.Conclusions Compared to CDUS,CEUS can raise the diagnosis accuracy in the hepatic malignnt tumors and is a useful technique in the differential diagnosis of benigh and malignant hepatic tumors.