超声造影功率多普勒谐频成像在肝肿瘤诊断中的应用

目的：评价功率（俗称“能量”）多普勒超声造影检测肝肿瘤内血流信号的能力。方法：对未治疗的56例57个肝脏占位性病变进行超声造影功率多普勒谐频成像检查，其中原发性肝癌47个，胆管细胞性肝癌3个，转移性肝癌3个，肝血管瘤2个，肝局灶性结节增生2个。所有病人注射造影剂后于早期动脉相观察肿瘤内的血流灌注情况，并与动态增强CT结果比较。结果：功率多普勒谐频成像显示肝肿瘤内造影增强80．7％（46／57）、负性增强19．3％（11／57）。与动态增强CT相比，功率多普勒谐频成像显示肿瘤内血流信号的敏感性、特异性和准确性分别为83．6％、100％和84．2％。肿瘤的深度是影响谐频成像结果的重要因素。结论：对一定深度范围内的肝肿瘤，功率多普勒谐频成 像可以敏感而准确地显示不同肝肿瘤的血流灌注情况，估计肿瘤血供特点，有助于肝肿瘤的诊断和鉴别诊断。

Contrast- enhanced harmonic power Doppler sonography of liver neoplasms

Purpose To evaluate detectability of tumor vascularity in various hepatic tumors with harmonic power Dppler sonography. Methods Fifty - six cases with 57 various hepatic tumors before treatment underwent Levovist - enhanced harmonic power Doppler sonography. Among them were 47 cases of hepatocellular carcinoma, 3 cases of cholangiocarcinoma, 3 cases of metastatic liver tumor, 2 cases of hemangiioma and 2 cases of focal nodular hyperplasia. Tumor vascularity of every tumor was evaluated at the early arterial phase after injection of Levovist, and compared with that of dynamic CT.Results Enhancement of tumor vascularity demonstrated by harmonic power Doppler sonography was detected in 46 of 57 (80.7%) tumors, and no enhancement was detected in 11 of 57 (19.3%) tumors. When compared with dynamic CT, the sensitivity, specificity and accuracy were 83.6% ,100% and 84.2% respectively,Depth,the distance between tumor and transducer on sonography,was a major factor that influenced the detectability of tumor vascularity by harmonic imaging. Conclusion Contrast - enhanced harmonic power Doppler sonography can depict tumor vascularity of various hepatic tumors sensitively and accurately, and is useful in the diagnosis of hepatic tumors clinically.