超声造影肝弥漫性病变的血流动力学表现及价值

Diagnostic value of hepatic perfusion flow in contrast enhanced ultrasound in various diffuse liver lesions

目的:探讨超声造影肝血流动力学参数在肝弥漫性病变中的表现及临床价值。方法:经肘静脉团注SonoVue造影剂0.6ml,利用时间-强度分析软件检测34例肝弥漫性病变和20例健康志愿者的肝血流动力学参数:肝动脉到达时间、肝动脉峰值时间、肝动脉峰值强度、肝静脉到达时间、肝静脉峰值时间、肝静脉峰值强度、肝动静脉渡越时间,与血清肝纤维化标志物检查对比并以病理结果对照。结果:肝硬化组肝动静脉渡越时间与正常组比较差异具有极其显著性意义(P<0.01),急性肝炎组肝动静脉渡越时间与正常组比较差异具有显著性意义(P<0.05),肝动静脉渡越时间评价轻、中度肝纤维化的符合率高于血清肝纤维化标志物检查(P<0.05)。结论:超声造影检测肝血流动力学参数诊断肝实质弥漫性病变有较高的临床应用价值。

Objective： To explore the value of detecting the changes of hepatic perfusion flow in diagnosis of diffuse liver lesions by contrast enhanced ultrasound. Methods： Thirty-four patients with various diffuse liver lesions and 20 normal subjects were recruited to be studied as control group. Each subject was administrated with a bolus injection of the ultrasound microbubble agent SonoVue（0.8ml） into an arm vein. The arrival times in the hepatic artery（ATHA）, time to peak in the hepatic artery（TTPHA）, peak intensity of the hepatic artery（PIHA）, arrival times in the hepatic vein（ATHV）, time to peak in the hepatic vein （TTPHV） and peak intensity of the hepatic vein （PIHV） were measured with the use of time-intensity curve software. The hepatic transit time（HTT） calculated from hepatic arrival times in the hepatic artery and the hepatic vein was compared with serum markers of hepatic fibrosis. Results： HTT was shorter in acute hepatitis group （P〈0.05） and significantly shorter in liver cirrhosis group （P〈0.01） than those of the control group. The coincidence rate in evaluating mild or moderate hepatic fibrosis by use of HTT was higher than that by use of serum markers of hepatic fibrosis（P〈0.05）. Conclusions： Detecting the changes of hepatic perfusion flow by contrast enhanced ultrasound may help the diagnosis of liver diffuse lesions.