肝脏肿瘤三维超声成像的临床意义

目的探讨彩色三维多普勒超声对肝脏实性占位病变形态、大小及内部血供的诊断价值.方法对常规灰阶超声显示有肝脏实性占位病变的患者28例,采用腹部彩色三维超声成像仪自由臂方式对肝脏病变处及其周围进行扫查取像,取样结束后在三维超声仪上进行脱机后处理,以病变处为中心,对X、Y、Z 3个互相垂直切面上的病变范围进行勾划,生成三维的肿瘤球体,计算程序可自动计算球体体积、内部血流容积及两者之比.结果肿瘤体积最大为117 cm3,最小为2.0 cm3.三维超声可显示肿瘤供给血管走行及其分支情况,并可透视肿瘤内部血管分布情况.部分病变在二维图像上显示为"晕环"、"绕行"的肿瘤周边血管,在三维重建后显示出"抱球征",展现血管全貌,进入肿瘤内部后呈现出"提篮征",发出多支小血管,显示了恶性肿瘤的血供特征.结论彩色三维超声可对肝脏实性占位性病变的形态、体积、周边及内部血供进行综合评价,丰富了超声诊断依据.

Significance of three-dimensional color Doppler imaging for the diagnosis of solid lesions in the liver

Objective To evaluate the value of three-dimensional (3-D) color Doppler imaging in the diagnoses of solid lesions in the liver. Methods A total of 28 patients who showed solid lesions in the liver by two-dimensional (2-D) ultrasonography were studied with 3-D ultrasound system (Tom Tec Company, Germany) in freehand style. The reconstruction of the lesions were rendered outline and the 3-D system calculated the volumes of the lesions and blood vessels inside. Results The largest lesion volume was 117 cm3 while the smallest one was only 2.0 cm3. The 3-D color Doppler imaging could entirely display the vessels around and inside the lesions. Vessel signs such as "halo" detouring" or "holding ball" were displayed entirely in the lesions supposed to be malignant. Conclusions Three-dimensional color Doppler imaging can provide more information for evaluating thing shape, volume and vessels inside and around the lesions in the liver.