胰腺实性局灶性病变超声造影与增强CT的对照研究

Contrast enhanced ultrasound of solid focal lesions of pancreas：comparison with contrast enhanced computed tomography

目的对照研究胰腺实性局灶性病变（s-FLPs）超声造影（CEUS）和增强CT（CECT）的增强表现及其诊断价值。方法采用低机械指数CEUS回顾性分析确诊的49例s—FLPs的增强模式，并与CECT进行比较，分析两者的诊断能力。结果①CEUS血管期肿块内可观察到微血管灌注过程；②CEUS的实质灌注双期增强模式与CECT的双期增强模式一致性为73．5％（36／49），CEUS的实质灌注早期与CECT的胰腺期增强水平的一致性可达87．8％（43／49），低／低增强是胰腺癌CEUS和CECT最常见共同增强模式。③比较CEUS与CECT的鉴别诊断能力，两种方法差别无统计学意义。结论CEUS与CECT的增强模式具有良好的一致性，两种方法对s-FLPs的诊断能力相近，CEUS有可能成为s-FLPs影像学诊断的一种重要无创方法。

Objective To assess the characterization and usefulness of contrast enhanced ultrasound （CEUS） to diagnose solid focal lesions of pancreas（s-FLPs） in comparison to contrast enhanced computed tomography（CECT）. Methods Forty-nine s FLPs with final diagnosis were studied with low mechanical index CEUS and CECT. The enhanced patterns and diagnostic capability of CEUS were analyzed, and these results were compared with those from CECT. Results （1） In CEUS, the perfusion of capillary could be detected in vascular phase. （2）The concordance of dual-phases enhanced patterns between CEUS and CECT was 73.5 0/00 （36/49）. The concordance of enhanced level between early parenchymatous perfusion phase in CEUS and pancreatic phase in CECT could achieve 87.8% （43/49）. Hypo/hypo enhancement was the most common enhanced pattern of pancreatic carcinoma in CEUS and CECT. （3）There was no statistical significance between CEUS and CECT in the differential diagnostic. Conclusions The concordance of enhanced patterns between CEUS and CECT is satisfactory. CEUS is similar to CECT in the differential diagnosis of s-FLPs. CEUS would become an important non invasive diagnostic method for s-FLPs.