实时谐波超声造影对肝门胆管癌的诊断价值

The value of contrast-enhanced harmonic ultrasound for hilar cholangiocarcinoma

目的：探讨实时谐波超声造影对肝门胆管癌的诊断价值。方法：30例病理证实的肝门胆管癌病例，分析病灶的增强时间、增强强度及增强方式，并比较造影前后病灶的清晰显示率。结果：肝门胆管癌平均在17．3s病灶开始增强，25．0s时增强达峰值，64．3s时回声已表现为低于周围肝实质。在门脉期及延迟期分别有50．0％（15／30）及93．3％（28／30）表现为低回声。73．3％（22／30）的病灶增强方式表现为整体增强。造影后，病灶清晰显示率从造影前的23．3％（7／30）提高到93．3％（28／30），差异有统计学意义。结论：实时谐波超声造影可显著提高病灶的清晰显示率，对于指导临床选择手术方式有重要意义。

Objective To evaluate the value of contrast-enhanced ultrasound （CEUS） in hilar cholangiocarcinoma. Methods Thirty cases of hilar cholangiocarcinoma confirmed by pathology performed CEUS,and the enhancement parameters of time,intensity and styles were observed. The clearly displaying rate was compared before and after CEUS. Results The lesions were medially enhanced at 17.3 second,and peak intensity arrived at 25.0 second, hypoechoic enhancement appeared at 64.3 second. The hypoechoic lesions were 50.0 % （15/30） and 93.3 % （28/30） compared with the liver parenchyma in portal vein phase and delayed phase, respectively. The most common enhancement style was homogeneous. The clearly displaying rate of the lesions was significantly improved from 23.30% （7/30） to 93.3%（28/30） after administering the contrast media. Conclusions CEUS could significantly improve the displaying rate of hilar cholangiocarcinomas,and have significant value for selecting appropriate therapy in clinic.