动态三维超声造影与增强CT/MRI对肝肿瘤成像质量的评价比较

摘要

目的 评价动态三维超声造影(3D-CEUS)显示肝肿瘤的影像质量.方法 对25例肝肿瘤患者进行二维超声、二维超声造影和动态3D-CEUS检查,超声检查前或后行增强CT或MRI (CECT/MRI)检查.分别对动态3D-CEUS图像和CECT/MRI影像资料评分,动脉期显示目标区域肿块灌注情况(不清0分,一般1分,清楚2分),各期综合显示目标区域肿块边界及与周围组织关系(不清0分,一般1分,清楚2分).Kappa检验评价两种影像方法结果的一致性.结果 25例动态3D-CEUS成功显影23例,CECT/MRI全部成功显影.灌注情况评分:动态3D-CEUS 2分16例,1分7例,0分2例;CECT/MRI2分18例,1分7例,0分0例,一致性检验Kappa值为0.65,P=0.00.肿块边界及周围组织关系评分:动态3D-CEUS 2分16例,1分7例,0分2例;CECT/MRI 2分21例,1分4例,0分0例,一致性检验Kappa值为0.52,P=0.00.结论 动态3D-CEUS对肝单发病灶能较完整、清楚地显示病灶灌注情况及周边关系,为二维超声提供补充,与CECT/MRI一致性良好,但对肝巨大肿块及多发病灶不能全面显影.%Objective To evaluate the image quality of dynamic three-dimensional contrast enhanced ultrasonography(3D-CEUS) in liver tumors.Methods Twenty-five patients were examed with 2D-CEUS and dynamic 3D-CEUS.Contrast-enhanced computed tomography or magnetic resonance imaging(CECT/MRI) were performed early or late.Two readers reviewed the images of both modalities and graded the images according to diagnostic criteria as follows:tumor blood fusion in arterial phase(unclear-score 0,moderate-score 1,clear-score 2),tumor boundry and relationship with periphery tissues (unclear score 0,moderate-score 1,clear-score 2).The concordance between the two modalities for showing liver tumors was evaluated by Kappa test.Results Twenty-three of 25 danymic 3D-CEUS were displayed successfully versus total objects in CECT/ MRI.Among them,for showing blood fusion,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 18 lesions scored 2,7 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.65.For showing tumor boundry and relationship with peripherytissues,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 21 lesions scored 2,4 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.52.Conclusions Danymic 3D-CEUS was shown to be useful for displaying tumor blood fusion,boundry and relationship with periphery tissues in single liver tuomor,the concordance between dynamic CEUS and CECT/MRI for single liver tuomor was fair.For huge liver tumor and multi-tumors,3D-CEUS can not give overall information.