肝血管瘤低机械指数连续成像超声造影的增强模式

目的 应用第二代超声造影剂和低机械指数连续成像技术探讨超声造影肝血管瘤的增强模式。方法 经周围静脉团注声诺维，用对比脉冲序列(CPS)技术对40例肝血管瘤患者施行超声造影，观察注射造影剂后肿瘤在动脉期(9～40s)、门静脉期(41～120s)及延迟期(121～360s)的增强情况。结果 40个(100％)结节均在动脉期出现增强，回声高于肝实质。在门静脉期和延迟期持续增强，其中36个(90．0％)结节回声始终高于肝实质，3个(7．5％)结节回声渐变为等于肝实质，1个(2．5％)结节回声渐变为低于肝实质。在动脉期，35个(87．5％)病灶呈周边结节状增强逐渐向中央扩展，3个(7．5％)病灶从中央开始不规则增强向周围扩展，2个(5．0％)病灶表现为全瘤均匀增强。在门静脉期和延迟期，病灶增强范围继续扩大，15个(37．5％)达到全瘤均匀增强，4个(10．0％)为不均匀增强，21个(52．5％)仍表现为周边结节状增强。结论 超声造影肝血管瘤增强模式的主要特点为动脉期增强，门脉期和延迟期持续性增强；从周边结节状增强开始，增强范围逐渐扩展。

Enhancement pattern of liver hemangioma at contrast-enhanced ultrasound with low mechanic index and continuous imaging method

Objective To evaluate the enhancement pattern of liver hemangioma at contrast-enhanced ultrasound with contrast agent SonoVue and low mechanical index and continuous imaging method. Methods(With bolus) injection of SonoVue via peripheral vein and an imaging technique of contrast pulse sequence(CPS), 40 patients with liver hemangioma underwent contrast-enhanced ultrasound examination. Scanning enhancement patterns of the tumors were observed at arterial phase(9-40 s), portal phase (41-120 s) and late phase (121-360 s).Results All 40 lesions were enhanced and presented as hypoechoic at arterial phase. At portal phase and late phase lesions were persistently enhanced with 36((90.0)%) hyperechoic, while 3((7.5)%) became isoechoic, 1((2.5)%) became hypoechoic. In arterial phase, periphery-to-center spotty enhancement was observed in 35 nodules((87.5)%), center-to-periphery with inhomogenous enhancement in 3((7.5)%), and whole-tumor with homogenous enhancement in 2((5.0)%). The enhanced area of tumors extended continuously at both portal phase and late phase. Fifteen((37.5)%) lesions were finally enhanced homogenously in whole-tumor, 4((10.0)%) were inhomogenously enhanced and 21((52.5)%) remained peripherally enhanced. Conclusions In contrast-enhanced ultrasound the characteristic enhancement pattern in liver hemangioma was shown enhancement at arterial phase and the enhancement was persistent at portal phase and late phase. Spotty enhancement raised from periphery of the tumor and the enhancement area gradually extended.