肾脏良恶性病灶微循环血流灌注定量分析中超声造影伽马拟合分析技术的应用

Quantitative analysis of microcirculation in renal solid lesions with gamma curve fitting technique of contrast-enhanced ultrasound

目的评估超声造影伽马拟合分析技术对肾脏肿瘤微循环血流灌注定量分析的价值。方法对50例肾脏实质内占位性病灶进行超声造影,将经DICOM3.0格式保存的动态图像导入SW-UCS-1型超声分析软件进行脱机分析,根据时间-强度曲线(TIC),得到上升支斜率(a_3)、下降支曲率(a_2)、达到时间(AT)、达峰时间(TTP)、基础强度(BI)、峰值强度、增强强度(AMP)、曲线下面积(AUC)、平均通过时间(MTT)、灌注指数(PI)等,并比较定量参数在肾脏恶性肿瘤和肾脏血管平滑肌脂肪瘤之间的差异。结果肾脏恶性肿瘤多见灌注模式为快进快出,而慢进慢出多见于肾脏血管平滑肌脂肪瘤。肾脏恶性肿瘤和肾脏血管平滑肌脂肪瘤灌注模式分别为:快进快出28例和0例,快进慢出4例和1例,慢进快出5例和1例,慢进慢出1例和10例。TIC分析定量参数a_3、AUC和PI在肾脏良恶性肿瘤比较中差异有统计学意义(P<0.05)。结论超声造影伽马拟合分析技术可以对肿瘤微循环血流灌注进行定量分析,有助于肾脏良恶性肿瘤鉴别。

Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrastenhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope （a3）, descending slope （ a2）, arrival time （ AT）, time to peak intensity （ TTP）, basic intensity （ BI）, peak intensity, amplification （AMP）, area under the curve （AUC）, mean transit time （MTT） and perfusion index （ PI）. The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and slow-out was found in renal angiomyolipoma （AML）. The perfusion modesin renal malignant tumors and renal AML were fast-in and fast-out in 28 cases and 0 case, fast-in and slow-out in 4 cases and 1 case, slow-in and fast-out in 5 cases and 1 case, and slow-in and slow-out in I case and 10 cases, respectively. There were significant differences in the quantitative parameters such as a3, AUC and PI between renal malignant tumors and renal AML obtained by the time-intensity curves （ P 〈 0. 05）. Conclusion Gamma fitting analysis of contrast-enhanced ultrasound system can provide quantitative information of microcirculation of renal tumors, which helps to differentiate benign renal tumors from malignant ones.