腹膜后占位性病变的超声造影时间-强度曲线的临床意义

Time-Intensity Curve of Contrast-Ultrasound in Evaluating Benign and Malignant Retroperitoneal Occupying Lesions

目的:分析腹膜后占位性病变的超声造影时间-强度曲线在形态和参数上有无差异,初步评估其对于鉴别腹膜后良恶性占位性病变的诊断价值。方法:选择腹膜后占位34例(良性12例,恶性22例)进行超声造影获得时间-强度曲线,将曲线下降支分为单相和双相,比较良恶性占位性病变在曲线下降支形态和曲线各参数中有无差异。结果:曲线下降支形态分析,单相组中恶性病变占94.4%,良性病变占5.6%;双相组中恶性病变占31.2%,良性病变占68.8%,差异有显著性(P=0.000 2)。曲线参数分析,良恶性组的上升支斜率(AS)差异具有显著性(P=0.000 1),良恶性组的峰值强度差异亦有显著性(P=0.01)。以AS=0.3为界,AS>0.3组别与AS<0.3组别差异具有显著性(P=0.000 6)。将时间-强度曲线的上升支斜率和下降支形态并联恶性肿瘤的漏诊率为9.19%。结论:超声造影时间-强度曲线对于腹膜后占位性病变的良恶性鉴别诊断具有一定的临床应用价值。

To compare the shape and kinetic parameters of the time-intensity curve （TIC） of real-time contrast-enhanced ultrasonography （CEUS） between benign and malignant retroperitoneal space-occupying lesions and to evaluate the application of TIC in differenting the two types of lesions. Methods： A total of 34 patients with retroperitoneal space-occupying lesions, including 12 benign and 22 malignant lesions, were performed with CEUS. The regions of interest （ROI） were chosen on the enhancement parts in the lesions in order to obtain the TIC. The shapes of the wash-out curve （descending branch） of TIC was divided into mono-phase or bi-phase patterns. The kinetic parameters of TIC were compared between benign and malignant lesions. Results： 94.4% of monophase lesions were malignant while 68.8% of bi phase lesions were benign （P= 0. 000 2）. The ascending slope （AS） of TIC of malignant lesions was significantly larger than that of benign group （P=0. 000 1）, and the peak intensity （PI） of malignant group was significantly higher than that of benign group too （P=0.01）. AS）0.3 could be used as an index to differentiate the malignant lesion from the benign one （P=0. 000 6）. Combined with the shape of descending branch, AS could reduce the rate of missed diagnosis in malignant lesions. Conclusion： The TIC of contrast-enhanced sonography provides a new way to discriminate the malignant from the benign in retroperitoneal space-occupying lesions.