声学造影剂及二次谐波成像在肝癌中应用浅谈.doc

声学造影剂及二次谐波成像在肝癌中应用浅谈 　关键词：声学造影剂二次谐波成像肝癌血管超声 　　摘要：目的：探讨微气泡型声学造影剂及二次谐波成像在肝癌中的应用特点。方法：22例肝癌病人经外周静脉注射造影剂前后(剂量0.5～1.0ml)行基波成像、彩色多普勒成像及二次谐波成像检查。二次谐波成像用1.7/3.4MHz(ATL-HDI5000)或1.8/3.6MHz(HP5500)。结果：肝动脉期肝脏多数无明显增强，少数病灶内出现斑点状回声增强，门静脉增强后肝组织才明显增强，但肿瘤组织增强不明显。增强后有利于低回声病灶的显示而对高回声病灶或中高混杂回声病灶显示无益。增强后可显示更多的瘤血管。彩色多普勒成像增强程度不及二次谐波成像，但结果相似。结论：微气泡型声学造影剂主要反映肝组织总体供血量的变化，相对于正常肝组织来说肝癌总是少血管的。造影剂及谐波成像可以改善血管的显示，谐波成像的组织定征能力有待进一步研究。 　　Theinitialstudyofsonographiccontrastagent　andsecondharmonicimagingonHCC 　　　Abstract:Purpose:Thisstudyistoevaluatemicrobubblebasedultrasoniccontrastagentandharmonicimagingonlivertumor.Methods:Beforeandaftermedia(Dosewasfrom0.5to1.0　ml)wereinjectedintoperipheralveinsof22ptientswithhepatocellulorcarcinoma(HCC),fundamentalimaging、colorDopplerimagingandsecondharmonicimagingwereperformed.SecondharmonicimagingwereperformedwithATL-HDI5000(1.7/3.4MHz)orHP5500(1.8/3.6MHz).SomecaseswerejustdetecedincolorDopplersonographywithLogiq500orAU4(3.5MHz)aftermediawereinjected.Results:Exceptsomespotenhancementonthelesionsoffivecases,therewerelittleenhancementcouldbenoticedonliveratarterialphase.However,afterportalveinswereenhancedobviously,theparenchymaofliverswereenhancedconsiderablebutnotofthetumors.Hypoechoicmasseswerewelldetectedafteradministrationofcontrastagents.Hyperechoicmassesandisohyperechoicmasseswerepoorlydetected.Themediaandharmonicimagingincreasedtheechointensityofnormalandtumorvesselsinliverlesions,thereweremorevesselscouldbeshowedaswell.Conclusion:Microbubblebasedagentismainlytoreflectthebloodperfusionofliveringenerally.HCCisalwayshypovascularinrelationtothenormalliver.Microbubblebasedagentandharmonicimagingimprovethevisualizationofvessels.Itisneededfurtherstudytoshowthetissuecharacteristicsbyharmonicimaging. 　　Keywords:contrastagent;secondharmonicimaging;livertumor;bloodvessel;ultrasound 　　近来经外周静脉注射用声学造影剂的研制取得较大进展，但该类造影剂在肝癌中的应用还较少［1］。二次谐波成像是超声技术的最新发展之一，它是利用声波在传播过程中部分能量转化为高次谐波的特性，进行非线性参量的计算机模拟成像［2］。我们用经外周静脉注射声学造影剂并行二次谐波成像，探讨它们在肝癌中的应用价值。 　　1　资料和方法 　　1.1　研究对象：22例1997