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目的 比较动态灰阶超声造影和增强CT显示肝肿瘤血流信号的特点。方法 对 49例病理证实的肝内实质性占位病变 (原发性肝癌 2 8例 ,肝血管瘤 9例和肝局灶性结节增生 12例 )进行超声造影和增强CT检查 ,比较两种影像技术在注射造影剂后不同时相的增强表现。结果 超声造影显示原发性肝癌中 85.7% (2 4/ 2 8)的肿块增强早于肝实质 ,门脉相和延迟相则多呈低回声 ;与增强CT显示 84.0 %(2 1/ 2 5)的肿瘤动脉期高密度、门脉期多呈低密度相一致。血管瘤中 67.7% (6/ 9)在超声造影的动脉相无明显增强 ,尔后逐渐向内部填充 ;与CT显示的造影剂逐渐填充呈结节状强化极为相似。肝局灶性结节增生在超声造影和增强CT上均显示早期快速增强 ,而消退较慢。 3种肿瘤在超声造影和增强CT不同时相的增强情况比较差异无显著性意义 (χ2 检验 ,P >0 .0 5)。结论 动态灰阶超声造影和增强CT都能敏感地显示不同肝肿瘤的血供特征 ,为肝肿瘤的鉴别诊断提供依据
Objective To compare the features of dynamic contrast-enhanced gray-scale contrast-enhanced ultrasound (CT-US) and enhanced CT (CT) in displaying liver tumor blood flow signals. Methods Contrast-enhanced ultrasound and enhanced CT were performed on 49 cases of pathologically confirmed intrahepatic solid lesions (28 primary hepatocellular carcinomas, 9 hepatic hemangiomas, and 12 focal nodular hyperplasias). Imaging technology enhances performance at different phases after injection of contrast agents. Results Contrast-enhanced sonography showed that 85.7% (24/28) of the primary liver cancers had enhancements earlier than the hepatic parenchyma; portal veins and delayed phases were mostly hypoechoic; and enhanced CT showed 84.0 % (2 1 / 2 5 The high density of the arterial phase of the tumor and the low density of the portal phase are consistent. Among the hemangiomas, 67.7% (6/9) had no significant enhancement in the arterial phase of contrast-enhanced ultrasound, and gradually filled inwards. Similar contrast enhancement with CT showed nodular enhancement. Liver focal nodular hyperplasia showed rapid early enhancement on contrast-enhanced ultrasound and enhanced CT, with slower regression. There was no significant difference in the enhancement of contrast-enhanced ultrasound and enhanced CT at all three types of tumors (χ2 test, P > 0.05). Conclusion Dynamic gray-scale contrast-enhanced ultrasound and enhanced CT can sensitively display the blood supply characteristics of different liver tumors, and provide the basis for the differential diagnosis of liver tumors.