胃腔充盈下超声联合谐波超声造影对胃间质瘤的诊断价值

摘要

Objective Through combining oral ultrasonic contrast agent with contrast-enhanced harmonic ultrasound, observe the gastric stromal tumor, investigate the ultrasonic features of gastric stromal tumor and reveal the application value of combining oral ultrasonic contrast agent with contrast-enhanced harmonic ultrasound in the diagnosis of gastric stromal tumor. Methods After drinking the oral ultrasonic contrast agent, study the lesions of gastric stromal tumors by two-dimensional ultrasound and then further study more detailed lesions by pulse inversion harmonic imaging (PIH) to analyze the perfusion features of al lesions. Results 30 cases were investigated in this study, including 19 cases of low-risk tumor and 11 cases of high-risk tumor. On contrast-enhanced harmonic ultrasound, the 19 cases of low-risk tumor showed smal er diameters (<5 cm), regular circular shape such as round or quasi-circular, rare internal liquefaction and necrosis, with relatively homogeneous enhancement;while the 11 cases of low-risk tumor showed large diameters (>5 cm), irregular lobulated shapes, irregular echoes, more internal liquefaction and necrosis, with nonhomogeneous enhancement except for the necrotic liquefaction area. Conclusion Oral ultrasonic contrast agent combining contrast-enhanced harmonic ultrasound can bet er display the morphology of gastric stromal tumor, contribute to a more exact diagnosis considering the microvascular perfusion state in necrotic area, which is of guiding and referential signiifcance to clinical treatment.%目的：应用胃腔充盈下超声联合谐波超声造影技术观察胃间质瘤，探讨胃间质瘤的超声特征及胃腔充盈下超声联合谐波超声造影技术在胃间质瘤诊断中的应用价值。方法口服胃窗声学造影剂后应用二维超声观察胃间质瘤病变，再以反向脉冲谐波显像技术对二维超声难以定性的病变行谐波超声造影检查，分析胃间质瘤的造影灌注特征。结果本组30例胃间质瘤，其中低危组19例，高危组11例。19例低危组胃间质瘤在谐波超声造影下多表现为肿瘤体积较小（直径<5 cm），形态较规则，多呈圆形或类圆形，内部液化、坏死少见，呈整体较均匀增强；19例高危组胃间质瘤在谐波超声造影下多表现为体积较大(直径﹥5cm)，形态不规则，多呈分叶状，瘤体内部回声不均匀，液化、坏死较多见，呈整体不均匀增强，坏死液化区不增强。结论胃腔充盈下超声联合谐波超声造影技术能够很好的显示胃间质瘤的形态范围，并能结合病变区域微血管灌注情况，对病灶的恶性潜能进行较准确的判断，可为临床治疗提供一定的指导意见。