逆行保留灌肠法结合实时超声造影对结肠病变的诊断价值

摘要

Objective Through combining hydrocolonic sonography with real-time contrast-enhanced ultrasound, observe the colonic lesions, investigate the blood perfusion features of both benign and malignant lesions in contrast-enhanced ultrasound (SEUS) and reveal the application value of hydrocolonic sonography in the diagnosis of colonic lesions. Methods Observing 64 participants with benignant or malignant colonic lesions through combing hydrocolonic sonography with CEUS to analyze benignant and malignant lesions’ performance in two-dimensional ultrasound and perfusion features in real-time contrast-enhanced ultrasound. Meanwhile, making use of the Qlab quantitative analysis software to analyze quantity, acquire time-density curve (TIC) and perfusion parameters arrival time (AT), time to peak (TTP), rise time(RT=TTP-AT), basic intensity(BI),peak intensity(PI), relative rise in intensity(EI=PI-BI). Results Image conditions were significantly improved by using hydrocolonic sonography comparing with conventional ultrasound. TIC analysis showed:there is no signiifcant difference in BI, PI, EI, AT, TTP, RT between benignant lesion group and normal controlled group (P>0.05);there is signiifcant difference in PI, EI, AT, TTP between colon cancer group and normal controlled group (P<0.05);there is signiifcant difference in PI and EI between the stromal tumor group and normal controlled group (P<0.05). Conclusion Combining hydrocolonic sonography with real-time contrast-enhanced ultrasound provides a clearer view of colonic wall layers, necrotic area, morphology, and with reference to the microvascular perfusion state in necrotic area, it is of significant diagnosis value in lesion location and benignant or malignant lesion identiifcation.%目的：应用逆行保留灌肠法结合超声造影技术观察肠道病变,探讨结肠良恶性病变的超声造影（contrast-enhanced ultrasound, CEUS）血流灌注特征及逆行保留灌肠超声在结肠疾病诊断中的应用价值。方法先逆行保留灌肠法超声结合实时超声造影技术观察结肠良恶性病变64例，分析结肠良恶性病变的二维超声表现及实时超声造影灌注特征。并采用Qlab定量分析软件进行定量分析，获取时间-强度曲线（TIC）及相关灌注参数到达时间（AT）、达峰时间（TTP）、上升时间（RT）、基础强度（BI）、峰值强度(PI)、强度相对值（EI）。结果逆行保留灌肠超声检查（hydrocolonic sonography, HS）法可显著改善常规超声对结肠显像的条件,TIC曲线分析结果示：结肠良性病变组参数BI、PI、EI、AT、TTP、RT与正常对照组比较差异均无统计学意义（P＞0.05），结肠癌组参数PI、EI、AT、TTP与正常对照组比较差异有统计学意义（P＜0.05），间质瘤组参数PI、EI与正常对照组比较差异有统计学意义（P＜0.05）。结论逆行保留灌肠法结合实时超声造影技术能够很好的显示肠壁层次结构，清晰显示病变部位及形态，并能结合病变区域微血管灌注情况，对病灶的定位、良恶性鉴别有更进一步的诊断价值。