实时超声造影对肝外胆管癌的诊断价值

Value of real-time contrast-enhanced ultrasound in diagnosis of extrahepatic cholangiocarcinoma

目的探讨实时超声造影对肝外胆管癌的诊断价值。方法16例经病理证实的肝外胆管癌病例,回顾性分析其超声造影时间—强度曲线,增强时间、增强强度以及病灶的增强方式,并比较病灶在造影前后的清晰显示率。结果肝外胆管癌病灶平均在(15.5±5.0)s开始显影增强,(22.0±4.5)s时增强达峰值,(55.0±8.5)s时造影剂开始消退,(85.5±20.0)s时廓清。在动脉相、门脉相及延迟相分别有30%(4/16)、60%(10/16)及6.2%(1/16)表现为等增强,分别有10%(1/16)、40.0%(6/16)及93.8%(15/16)表现为无增强,有70%(11/16)在动脉相表现为高增强。75%(12/16)的病例表现为整体增强,造影后病灶的清晰显示率从造影前的53.0%(9/16)提高到造影后的93.8%(15/16)。结论超声造影可显著提高肝外胆管癌病灶的显示率,为临床提供可靠的诊断依据。

Objective To evaluate the value of real-time contrast-enhanced ultrasound in diagnosis of extrahepatic cholangiocarcinoma. Methods Sixteen cases of extrahepatic cholangiocarcinoma comfirmed by pathology were enrolled in this study. Their time-intensity curves, enhanced time, enhanced intensity and enhanced types of lesion were analyzed retrospectively. Then the clear display rate of lesions was compared before and after CEUS. Results The leision were medially enchanced at （ 15.5± 5.0） s, and peak intensity retired at （ 22.0 ± 4.5 ） s, hypoechoic enchaneement appeared at （ 55.0±8.5 ） s, and display clearly at （85.5 ± 20.0） s. The hypoechoic leisions were 10% （ 1/16）, 40% （9/16） and 93.8% （15/16） in arterial phase ,portal phase and delayed phase, respectively. The equal echoic lesions were 30% （4/16） ,60% （10/16） and 6. 2% （1/16）in arterial phase ,portal phase and delayed phase, respectively. Only the 70% （11/16）were hyperechoic leisions in arterial phase. The appearance of 75% （ 12/16 ） cases was enhanced globally. The clear display rate of lesions was significantly improved from 53.0% （9/16） to 93.8% （15/16） after CEUS. Conclusion CEUS can significantly improve the display rate of extrahepatic cholangiocarcinoma, and can provide more reliable information in clinic.