目的 探讨不同组织来源肝脏微小恶性肿瘤超声造影动态血流灌注的增强模式及参数变化特征.方法 对39例超声诊断为恶性病变(直径小于或等于2 cm)并经病理证实的病例进行回顾性研究,定量分析增强模式及灌注参数.结果 (1)39例病例中,原发性肝癌25例,转移性肝癌14例.超声造影诊断符合率:肝细胞癌86%、胆管细胞癌67%、多血管转移性肝癌75%、少血管转移性肝癌83%.(2)肝癌在超声造影的过程中均见增强,不同类型肝癌的增强方式不同(P<0.01).(3)肝细胞癌、多血管转移性肝癌和少血管转移性肝癌组的达峰时间(TTP)、峰值强度(PI)两两组间比较差异有统计学意义(P<0.05).结论 超声造影增强模式及灌注参数变化特征能为不同组织来源的肝脏微小恶性病变的诊断及鉴别诊断提供客观指标.%Objective To investigate the enhanced type and the features of the parameters variation of ultrasound contrast dynamic blood perfusion in the malignant hepatic tumors from different tissues. Methods Thirty-nine patients with small malignant hepatic lesions(diameter of lesions=2 cm) diagnosed by pathology and Contrast-enhanced ultrasound were studied retrospectively. And perfusion parameters and the enhanced type of blood perfusion were analyzed quantitatively. Results (1)25 cases of primary malignant hepatic tumors and 14 cases of metastatic hepatic tumors were found in 39 cases of malignant hepatic tumors diagnosed by pathology. 86% of hepatocellular carcinoma, 67% of intrahepatic cholangiocarcinoma, 75% of multi-vascular metastatic hepatic tumors and 83% of less-vascular metastatic hepatic tumors were diagnosed by Contrast-enhanced ultrasound correctly. (2)The enhanced type of blood perfusion in the hepatocellular carcinoma mostly was detected as whole-lesion enhanced and different enhanced types were demonstrated in malignant hepatic tumors from different tissue(P<0. 01). (3)There were obvious differences in the peak time and the time to peak of hepatocellular carcinoma , multi-vascular metastatic hepatic tumor and less-vascular metastatic hepatic tumor(P<0. 05). Conclusion The enhanced type and the features of parameters variation of ultrasound contrast dynamic blood perfusion can provide the objective evidence for differential diagnosis of malignant hepatic lesions from different tissue.
展开▼
