超声造影在肝脏局灶性病变中的应用概要1.doc

实时超声造影在肝脏局灶性病变诊断中的应用 李开艳 罗鸿昌 巴桑 陈云超 张青萍 【摘 要】目的 评价实时超声造影技术在肝脏局灶性病变诊断中的作用及意义。方法 采用实时超声造影技术，对我院269例肝脏局灶性病变进行超声造影检查。结果 92.4％恶性病变动脉相呈现回声增强。病灶动脉相呈现高或等增强、至延迟相消退为低或无增强，在良性病变中占13.8％（19/138），恶性病变中为94.7％（124/131）。本次研究中，实时超声造影诊断肝脏局限性病灶的敏感性89.6%，特异性97.5%，准确性93.2%。结论 实时超声造影可显示肝局灶性病变的血流灌注特点,对肝局灶性病变的分类诊断有重要的应用价值。 【关键词】 超声检查； 造影剂；肝疾病 Clinical study of real time contrast-enhanced ultrasound on differential diagnosis of focal liver lesions LUO Hong-chang, LI Kai-yan, BA Sang, CHEN Yun-chao, ZHANG Qing-ping Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College , Huazhong University of Science and Technology, Wuhan 430030, China [Abstract] Objective To evaluate the availability and significance of real time contrast-enhanced ultrasound on differential diagnosis of focal liver lesions . Methods Real time contrast-enhanced ultrasound was used for differential diagnosis of focal liver lesions in 269 cases. Results 92.4% of malignant focal liver lesions showed enhancement during arterial phase. In lesions with hyper- or iso-enhancement during arterial phase then subsiding to hypo- or non-enhancement in late phase , the benign focal liver lesions was 13.8%(19/138) whereas the malignant focal liver lesions was 94.7%(124/131). In this study the sensitivity, specificity and accuracy of diagnosis of focal liver lesions with real time contrast-enhanced ultrasound were 89.6%, 97.5% and 93.2%. Conclusions Real time contrast-enhanced ultrasound is sensitive and accurate in demonstrating hemodynamic features of focal liver lesions ,and it can be a promising technique on differential diagnosis of focal liver lesions. [Key words] Ultrasonography；Contrast media；Liver diseases 肝脏的影像学检查经历了近15年的变化[1]。超声是肝脏影像检查的首选方法，但灰阶超声和彩色多普勒超声在肝脏局灶性病变的定性诊断中存在一定的局限性[2,3]，随着超声造影技术的不断发展和第2代超声造影剂声诺维（Sonovue）的应用，可实时反映病变的增强情况，尤其在肝脏局灶性病变应用中可有效反映病变的血流动力学变化[4]。本研究探讨Sonovue超声造影技术在肝脏局灶性病变诊断中的应用价值。 资 料 与 方 法 一、研究对象 2005年11月－2006年10月，对我科常规超声诊断为肝脏局灶