动态三维超声造影在肝肿瘤诊断中的初步应用

摘要

目的 探讨动态三维超声造影(3D-CEUS)在诊断肝肿瘤中的应用价值.方法 选择在我院诊治的51例肝占位患者共55个病灶,造影剂选用SonoVue,依次对病灶进行二维超声、彩色多普勒超声、常规超声造影和动态3D-CEUS检查,并对动态3D-CEUS图像进行处理和分析.观察超声造影的增强方式、不同时期肿瘤血管清晰度及立体感等情况并进行评分.结果 本组肝占位病灶动态3D-CEUS显示动脉期肿瘤血管及肿瘤立体感最好,而门脉期较差.动态3D-CEUS诊断肝肿瘤的符合率为92.7%(51/55),其中诊断肝恶性肿瘤的符合率为97.0%(39/40),诊断肝良性病变的符合率为80.0%(12/15).结论 动态3D-CEUS可更直观、动态和有效地显示肝肿瘤血供和空间立体关系,为提高超声诊断肝肿瘤的准确性提供了新的手段.%Objective To evaluate the value of dynamic three-dimensional contrast-enhanced ultrasonography ( 3D-CEUS ) in diagnosis of liver tumor. Methods 3D-CEUS was performed in 51 patients ( 55 lesions ), including 32 primary liver tumors ( PLT ), 6 metastatic liver tumors ( MLT ), 1 epithelioid hemangioendothelioma, 1 hepatoblastoma, 5 hemangiomas, 3 focal nodular hyperplasias( FNH ), 2 inflammatory pseudotumors, 1 adenoma and 4 inflammatory lesions. Contrast media is SonoVue and iU22 was selected with X6-1 volumetric probe. After application of SonoVue, dynamic 3D enhanced patterns of lesions, as well as definitions and three-dimensional appearances of tumor vessels were observed and scored. Results After intravenous injection of contrast media, most of liver tumors had best definition and 3D appearance at arterial phase by dynamic 3D-CEUS, however, those performances were poor at portal vein phase. The accuracy of liver tumors diagnosed by dynamic rn3D-CEUS was 92. 7％ ( 51/55 ) [ malignant 97. 0％ ( 39/40 ), benign 80. 0％ ( 12/15 ) ]. Conclusion Dynamic 3D-CEUS can directly display the blood supply in tumor and spatial relationships effectively and provide a new method to improve the accuracy in the diagnosis of liver tumors.