肝占位性病变的超声造影双向脉冲谐频成像表现

目的：探讨不同的肝占位性病变在超声造影编码双向脉冲谐频成像时的表现特征。方法：对未治疗的73例患者肝细胞性肝癌,胆管细胞性肝癌,转移性肝肿瘤、肝血管瘤和肝局灶性结节增生）共80个肝占位性病变进行超声造影下的编码双向脉冲谐频成像检查,并于造影后比较肿瘤内与肝实质的血流信号强度。结果：原发性肝癌中93．1％（54／58）在超声造影谐频成像的连续成像上表现为造影增强,并可动态显示内部增生扭曲的肿瘤血管：77．6％（45／58）在间歇成像上呈现造影增强,显示肿瘤的灌注血流。胆管细胞性肝癌中100％（3／3）在连续成像上呈现造影增强,显示的肿瘤血管较粗大;间歇成像则显示66．7％）2／3）造影增强。转移性肝肿瘤表现为肿瘤周边部信号增绐,肝血管瘤在间歇成像上显示肿瘤内的发布不均匀,呈现“棉絮”证。肝局灶性结节增生则可显示其中央动脉及放谢状分支供血的特征性表现。结论：超声造影编码双向脉冲谐频成像可敏感地显示肝占位性病变内的血流信号,不同的占位性病变呈现不同的造影增强表现,有助于肝占位性病变的诊断的鉴别诊断。

Characterization of liver solid lesions on contrast-enhanced phase-inversion harmonic imaging

Objective To investigate the characterization of hepatic tumors on contrast enhanced phase inversion harmonic imaging. Methods Seventy three patients with 80 various liver solid lesions were examined by coded harmonic angio (CHA) mode with an intravenous administration of Levovist. The enhancements of every hepatic lesion and liver parenchyma were compared. Results Among hepatocellular carcinomas, 93.1 % (54/58) and 77.6 % (45/58) positive enhancement was found on continuous imaging and interval delay imaging of CHA, respectively. It depicted proliferated winding tumor vessels in a real time fashion in hepatocellular carcinomas. In similar, 100% (3/3) cholangiocarcinomas were enhanced on continuous imaging of CHA and 66.7 % (2/3) on interval imaging, and their tumor vessels were relatively large. Metastatic liver tumors were demonstrated as peripheral enhancement. Hemangiomas were shown less flow signals than liver parenchyma and acted as "cotton wool" sign. Special pattern with feeding artery and its radiating branches were demonstrated in focal nodular hyperplasias.Conclusions Contrast enhanced CHA mode could depict special flow signals in hepatic tumors sensitively, which would be helpful in the diagnosis and differential diagnosis of hepatic tumors.