1.2 ml声诺维在肝脏占位病变超声造影中的作用探讨
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摘要
目的初步探讨1.2 ml声诺维在肝脏占位病变超声造影检查中的应用价值。方法选取51例使用1.2 ml声诺维(1.2 ml组)和83例使用2.4 ml声诺维(2.4 ml组)行肝脏占位病变超声造影的患者,比较两组超声造影动脉相血流灌注的主要增强方式,对比肝脏良恶性占位病变的时间-强度曲线(TIC)形态特征,分析肝脏占位病灶与周围肝实质血流灌注参数,包括始增时间(AT)、达峰时间(TTP)、上升时间(Δt)、本底强度(Ib)、峰值强度(Ip)、增强强度(ΔI)及ΔI/Δt,以及两组肝脏占位病灶血流灌注参数的差异。结果两组声诺维超声造影下恶性和良性占位病变的主要增强方式相同,恶性占位病变的增强方式主要为整体型和周边增强型,TIC波峰较尖锐。1.2 ml组肝脏占位病变与周围肝实质AT、TTP、Δt、Ib、Ip、ΔI/Δt比较差异均有统计学意义(均P<0.05)。与2.4 ml组比较,1.2 ml组周围肝实质和肝占位病变的AT、TTP、Ib差异均有统计学意义(均P<0.05),1.2 ml组肝血管瘤的TIC参数仅AT差异有统计学意义,肝癌(原发性肝细胞癌和转移性肝癌)的TIC参数仅Ib差异有统计学意义(均P<0.05)。结论使用1.2 ml声诺维行超声造影检查可以较好地显示肝脏占位病变,特别是对肝癌和肝血管瘤的显示,具有较好的临床应用价值。
Objective To explore the application value of 1.2 ml SonoVue in the diagnosis of liver lesions by contrastenhanced ultrasonography(CEUS).Methods A total of 51 patients(1.2 ml group)and 83 patients(2.4 ml group)were selected for CEUS. The main enhancement modes of arterial perfusion of CEUS between the two groups were compared. Timeintensity curve(TIC)morphological features of benign and malignant lesions in the liver were compared. The blood perfusion parameters of liver-occupying lesions and peripheral hepatic parenchyma,and the differences in blood perfusion parameters(AT、TTP、Δt、Ib、Ip、ΔI and ΔI/Δt) between the two groups of liver-occupying lesions were analyzed.Results The main enhancements of malignant and benign liver-occupying lesions were the same in two groups. The enhancement of malignant liver-occupying lesions was mainly holistic and peripheral enhancement,and the peak of TIC was sharp. There were significant differences in TIC perfusion parameters AT,TTP,Δt,Ib,Ip,ΔI/Δt between the 1.2 ml group and the surrounding liver parenchyma(all P<0.05). Compared with the 2.4 ml group,there were significant differences in the TIC perfusion parameters AT,TTP and Ib in the 1.2 ml group and the surrounding liver parenchyma(all P<0.05). Compared with the 2.4 ml group,only AT had statistically significant difference in the TIC perfusion parameters of liver hemangioma in the 1.2 ml group(P<0.05),and only Ib had statistically significant difference in the TIC perfusion parameters of liver cancer(HCC and MLC).Conclusion Using 1.2 ml SonoVue for CEUS can better display liver-occupying lesions,especially for liver cancer and hemangioma,which has good clinical application value.
Objective To explore the application value of 1.2 ml SonoVue in the diagnosis of liver lesions by contrastenhanced ultrasonography(CEUS).Methods A total of 51 patients(1.2 ml group)and 83 patients(2.4 ml group)were selected for CEUS. The main enhancement modes of arterial perfusion of CEUS between the two groups were compared. Timeintensity curve(TIC)morphological features of benign and malignant lesions in the liver were compared. The blood perfusion parameters of liver-occupying lesions and peripheral hepatic parenchyma,and the differences in blood perfusion parameters(AT、TTP、Δt、Ib、Ip、ΔI and ΔI/Δt) between the two groups of liver-occupying lesions were analyzed.Results The main enhancements of malignant and benign liver-occupying lesions were the same in two groups. The enhancement of malignant liver-occupying lesions was mainly holistic and peripheral enhancement,and the peak of TIC was sharp. There were significant differences in TIC perfusion parameters AT,TTP,Δt,Ib,Ip,ΔI/Δt between the 1.2 ml group and the surrounding liver parenchyma(all P<0.05). Compared with the 2.4 ml group,there were significant differences in the TIC perfusion parameters AT,TTP and Ib in the 1.2 ml group and the surrounding liver parenchyma(all P<0.05). Compared with the 2.4 ml group,only AT had statistically significant difference in the TIC perfusion parameters of liver hemangioma in the 1.2 ml group(P<0.05),and only Ib had statistically significant difference in the TIC perfusion parameters of liver cancer(HCC and MLC).Conclusion Using 1.2 ml SonoVue for CEUS can better display liver-occupying lesions,especially for liver cancer and hemangioma,which has good clinical application value.
引文
[1]唐静,王飞.超声造影诊断肝内肿块性质的临床价值分析[J].中国肿瘤外科杂志,2018,10(1):50-51.
[2]杜联芳,苏一巾,李凡,等.声诺维造影剂量与肝占位图像质量的对比研究[J].中国超声医学杂志,2007,23(3):215-217.
[3]王艳红,钱林学.造影剂剂量对健康成年人肝脏超声造影定量分析的影响[J].中华医学超声杂志(电子版),2014,11(12):953-957.
[4]丁雪明.肝占位病变超声造影定量对比研究及HCC造影定量参数与病理微血管的关系[D].南宁:广西医科大学,2009.
[5] Ignee A,Jedrejczyk M,Schuessler G,et al. Quantitative contrast enhanced ultrasound of the liver for time intensity curves rehability andpotentialsourcesoferrors[J].EurJRadiol,2010,73(1):153-158.
[6]王知力,唐杰,鲁通,等.肝局灶性病变的超声造影定量分析及其在定性诊断中的意义[J].中华超声影像学杂志,2006,15(8):576-579.
[7] Zocco MA,Garcovich M,Lupascu A,et al. Early prediction of response to sorafenib in patients with advanced hepatocellular carcinoma:the role of dynamic contrast enhanced ultrasound[J].Hepatol,2013,59(5):1014-1021.
[8]刘红磊.肝良恶性肿瘤超声造影定量分析对比研究[D].石家庄:河北医科大学,2007.
[9] Yang YL,Yang RJ,Liu X,et al. Correlations between the timeintensity parameters of contrast-enhanced ultrasound and clinical prognosis of hepatocellular carcinoma[J].Clin Imaging,2013,37(2):308-312.
[2]杜联芳,苏一巾,李凡,等.声诺维造影剂量与肝占位图像质量的对比研究[J].中国超声医学杂志,2007,23(3):215-217.
[3]王艳红,钱林学.造影剂剂量对健康成年人肝脏超声造影定量分析的影响[J].中华医学超声杂志(电子版),2014,11(12):953-957.
[4]丁雪明.肝占位病变超声造影定量对比研究及HCC造影定量参数与病理微血管的关系[D].南宁:广西医科大学,2009.
[5] Ignee A,Jedrejczyk M,Schuessler G,et al. Quantitative contrast enhanced ultrasound of the liver for time intensity curves rehability andpotentialsourcesoferrors[J].EurJRadiol,2010,73(1):153-158.
[6]王知力,唐杰,鲁通,等.肝局灶性病变的超声造影定量分析及其在定性诊断中的意义[J].中华超声影像学杂志,2006,15(8):576-579.
[7] Zocco MA,Garcovich M,Lupascu A,et al. Early prediction of response to sorafenib in patients with advanced hepatocellular carcinoma:the role of dynamic contrast enhanced ultrasound[J].Hepatol,2013,59(5):1014-1021.
[8]刘红磊.肝良恶性肿瘤超声造影定量分析对比研究[D].石家庄:河北医科大学,2007.
[9] Yang YL,Yang RJ,Liu X,et al. Correlations between the timeintensity parameters of contrast-enhanced ultrasound and clinical prognosis of hepatocellular carcinoma[J].Clin Imaging,2013,37(2):308-312.