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目的 探讨实时超声造影在肝肿瘤诊断中的价值。方法 对 2 9例患者共 3 4个肝内实质占位病变进行实时谐波超声造影检查 ,其中 16个原发性肝癌 ,4个转移性肝癌 ,9个肝血管瘤 ,5个局灶性结节性增生。结果 经超声造影后 ,3 4个病灶均有不同程度的增强并有不同的增强特点。肝癌表现多为整体快速增强 ,呈不均状 ,并在门脉期快速消退 ;肝血管瘤多呈周围向心性增强 ,呈环状或周围结节状 ,并持续较长时间 ;肝局灶性结节性增生表现为中央扩散型快速均匀增强 ,并充盈整个门脉期。如以肝肿瘤在动脉期增强而在门脉期减退呈低回声作为诊断肝癌的指标 ,则超声造影诊断肝癌的敏感性、特异性及准确性分别为 95 %(19/2 0 )、10 0 %(14 /14 )和 97%(3 3 /3 4)。结论 实时超声造影能反映不同肝肿瘤在不同时相上的不同表现 ,可帮助提高肝肿瘤超声诊断的准确性。
Objective To explore the value of real-time contrast-enhanced ultrasound in the diagnosis of liver tumors. Methods Real-time harmonic contrast-enhanced ultrasound (CEUS) was performed on 34 intrahepatic real-mass lesions in 29 patients, including 16 primary liver cancer, 4 metastatic liver cancer, 9 hepatic hemangioma and 5 focal nodes Festival of hyperplasia. Results After ultrasound contrast, 34 lesions were enhanced to varying degrees with different enhancement features. Hepatic carcinoma mostly showed rapid enhancement as a whole, showing a non-uniform shape and rapidly dissipated in the portal phase. Hepatic hemangiomas mostly showed concentric or annular nodules and continued for a long time. Nodular hyperplasia manifested as a rapid and uniform central diffusive enhancement, and filling the entire portal phase. For example, the sensitivity, specificity and accuracy of contrast-enhanced ultrasonography in the diagnosis of hepatocellular carcinoma were 95% (19/2), 100 % (14/14) and 97% (3 3/34). Conclusion Real-time contrast-enhanced ultrasound can reflect the different manifestations of different liver tumors in different phases, which can help to improve the accuracy of ultrasonic diagnosis of liver tumors.