肝结核低声压实时超声造影表现

摘要

Objective To investigate the appearance and characteristics of hepatic tuberculosis lesions on low mechanical index contrast-enhanced ultrasound. Methods Eight patients with hepatic tuberculosis lesions were studied with conventional ultrasound and contrast-enhanced ultrasound. Lesions,distribution.size,echogenieity,blood flow,enhancement phase,enhancement patterns and intensity were studied. ResuIts Fifteen lesions were found in eight patients. On conventional ultrasound,mean size of the lesions was(21.7±10.7)mm×(30.3±22.4)mm,and 66.7%(10/15)lesions located under liver capdule,and 33.3%(5/15)were in hepatic parenchyma.All lesions were hypoechoic except the largest one (50 mm x 102 mm)which demonstrated heterogeneous.Doppler signals were not demonstrated in all 15 lesions.After administration of SonoVue,satisfied image data were obtained in 13 lesions for aterial phase,and 15 lesions for portal venous phase and parenchyma phase.84.6%(11/13)of the lesions demonstrated hyperenhancing on aterial phase,mean enhancing start time was(8.6±1.6)s,ranging from 5 s to 10 s.and mean enhancing end time was(25.6±2.8)s,ranging from 20 s to 29 s. Of 13 lesions,6 lesions demonstrated circle periphery hyper-enchanCement,5 lesions demonstrated whole hyper-enchancement,and 2 lesions appeared hypoenhancement on arterial phase. All lesions demonstrated either hypoenhancing or non-enhancement on portal venous phase and parenchyma phase. Conclusions Low mechanical index contrast-enhanced ultrasound can reveal the blood flow status of hepatic tuberculous lesions and will facilitate the diagnosis of hepatic tuberculosis.%目的 观察肝结核低声压实时超声造影表现.方法 对8例肝结核患者进行常规超声检查,然后对每个病灶进行超声造影检查,对造影录像进行回放分析,分析每一病灶增强的时相、模式及强度等特征.结果 8例肝结核共15个病灶,病灶大小(21.7±10.7)mmx(30.3±22.4)mm.66.7%(10/15)的病灶位于肝被膜下,33.3%(5/15)的病灶位于肝实质内.14个病灶为低回声.彩色多普勒显示病灶内均未见明确血流信号.13个病灶获得了完整连续的造影动脉期录像,其中84.6%(11/13)的病灶动脉期表现为中一强回声,增强的起始时间为5～10 s,平均(8.6±1.6)s,消退时间为20～29 s,平均(25.6±2.8)s;6个病灶表现为环形强回声,5个病灶为整体强回声,2病灶为整体低回声.15个病灶获得了完整连续的门静脉期及肝实质期录像,门脉期及肝实质期病灶均为低回声或无回声.结论 超声造影可清晰显示肝结核病灶的血流灌注状况,在肝结核的诊断中有重要价值.