肝恶性肿瘤的超声造影定量分析

目的 探讨肝恶性肿瘤超声造影（CEUS）的时间-强度曲线（TIC）形态和声学定量参数变化特征。方法 应用反向脉冲谐波显像（PIH）技术对48例肝恶性肿瘤患者行实时CEUS检查，以声学定量软件绘制病灶的TIC，分析TIC形态和定量参数变化特征。结果 48例肝恶性肿瘤中，16例原发性肝癌（HCC）、23例肝转移癌（metastasis livercancer，MLC）TIC形态呈快上快下型，4例小HCC、5例MLC呈快上慢下型；HCC中，小HCC降支减半时间迟于非小肝癌（P＜0．01）；MLC降支减半时间早于HCC（P＜0．05）；20s增强强度比较，乏血供MLC低于HCC及富血供MLC（P＜0．01），后二者之间差异无统计学意义。结论 CEUS的TIC形态和定量参数变化特征对肝恶性肿瘤的诊断及鉴别有重要价值。

Quantitative analysis of contrast-enhanced ultrasound on malignant liver tumors

Objective To investigate the types and changes of time-intensity curve(TIC) of contrast-enhanced ultrasound(CEUS) used in diagnosing malignant liver tumors.Methods Forty-eight patients with malignant liver tumors were observed with pulse inversion harmonic imaging technique.The types of TIC and the acoustic quantified parameter were analyzed.Results TIC showed quick-up and quick-down types in 16 cases with hepatocellular carcinoma(HCC) and 23 cases with liver metastases,as well as quick-up and slow-down types in 4 cases with small HCC(SHCC) and 5 cases with liver metastases.The half time of descending in the SHCC were significantly later than those in the non-SHCC(P<0.01).The half time of descending in liver metastases were significantly earlier than those in HCCs(P<0.05).The intensity of 20 s after the injection of contrast agent in the hypoperfused metastases were significantly lower than those in HCCs and hyperperfused metastases(P<0.01),while there were no significance between the two latter.Conclusions The type of TIC and acoustic quantified parameters of CEUS are valuable to diagnose and differentiate the malignant liver tumors.