肝肿瘤实时超声造影45例分析

Real Time Contrast-enhanced Ultrasonography of Hepatic Tumors

目的:探讨实时超声造影在肝肿瘤诊断中的应用价值。方法:经静脉注射造影剂SonoVue后,对45(男24、女21)例肝肿瘤患者(共63个病灶),在低机械指数状态下进行实时超声造影检查,并对录像资料进行回放、分析诊断,与基础超声诊断结果进行比较,通过病理证实。结果:基础超声、实时超声造影对肝肿瘤病灶的检出率分别为87．3％和96．8％,最大径小于1．0 cm的肿痛,基础超声、实时超声造影对肝肿瘤病灶的检出率分别是4I．7％和83．3％。基础超声有52．4％(33／63)的肿瘤边界显示不清晰,实时超声造影有6.3％(4／63)的肿瘤边界显示不清。对肝恶性肿瘤的诊断,基础超声诊断的敏感性、特异性、准确性分别是51．4％、66．7％和56．4％;实时超声造影诊断的敏感性、特异性、准确性分别为95．3％,94．4％和95．1％,两者之间差异具有统计学意义(P<0．05)。结论:实时超声造影在发现肿瘤数目、大小、边界较基础超声提供的信息多,实时超声造影对肝肿瘤性质鉴别优于基础超声。

Objective： To assess the real time contrast-enhanced ultrasound （RTCEUS） at diagnosing hepatic tumors. Methods： Forty five patients （24 men, 21 women） with 63 tumors,which were confirmed by pathological findings,were examined by RTCEUS at low MI （0.05 0.08） after intravenous injection of SonoVue.The results were recorded and compared with that from baseline ultrasound. Results： The recall ratio of baseline ultrasound and RTCEUS was 87.3O/o and 96.8% respectively. For the tumors whose maximum diameter were under 1.0 cm, the recall ratio of baseline ultrasound and RTCEUS was 58.3 % and 16.7% respectively. 52.4% （33/63）tumors＇ edge was shown unclearly when observed through baseline ultrasound, while for the RTCEUS, only 6.3%（4/68）tumors＇ edge was not shown clearly. The sensitivity, specificity and accuracy of baseline ultrasound in diagnosing malignant tumor of liver was 51.4%,66.7% and 56.4%. As for RTCEUS, they were 95.3%,94.4% and 95.1%. The dif- ference was statistically significant （P 〈0.05）. Conclusion： RTCEUS can provide much information about the number, size and edge of hepatic tumors than baseline ultrasound can do. It is superior to baseline ultrasound in the identification of hepatic tumors.