能量多普勒和TCCS联合应用在诊断脑肿瘤中的价值

Evaluation of Clinical Value of Power Doppler Based on TCCS in Diagnosing Brain Tumors

目的：通过超声诊断２９例脑肿瘤，评价在ＴＣＣＳ检查的基础上运用能量多普勒对脑肿瘤诊断的临床应用价值。方法：经颞窗和枕窗对２９例脑肿瘤患者进行ＴＣＣＳ检查，采用能量多普勒显示肿瘤病灶外周及内部血流分布状况，将血流信号分级进行半定量评价。结果：ＴＣＣＳ共检出脑肿瘤２８例，漏诊１例。１２例Ⅲ－Ⅳ级胶质瘤均呈强回声，６例（５０％）内部可见明显低回声区；其余１６例Ⅰ－Ⅱ级胶质瘤、脑膜瘤和垂体瘤中１３例呈强回声，回声均匀。肿瘤内血流信号能量多普勒显示分级：１２例恶性胶质瘤中１０例（８３．３％）３级，２例２级；１６例分化较好的脑肿瘤中３例２级，１３例０－１级。１２例恶性胶质瘤Ｖｍａｘ＝２１．７０±９．２９ｃｍ／ｓ，ＰＩ＝０．６８±０．２５。结论：在ＴＣＣＳ检查基础上采用能量多普勒能较好显示脑肿瘤内血运情况，提高良、恶性脑肿瘤的鉴别诊断率。

Objective:To evaluate clinical value of power Doppler based on TCCS in diagnosing brain tumors.Methods:29 patients with different brain tumors were undertaken TCCS examination through temporal and occipital accoustic windows.Power Doppler was used to display blood supply within the tumors.Blood signals were defined as grade 0,1,2,3 to perform semi quantitative analysis.Results:28 of 29 cases of brain tumors were diagnosed by TCCS.12 cases of gliomas (grade Ⅲ to Ⅳ) were hyperechoic,6 of them were inhomogeneous.13 of 16 cases of gliomas (grade Ⅰ to Ⅱ),meningiomas and pituitary adenomas were also hyperechoic but homogeneous.As to blood signals detected by power Doppler,10 of 12 cases of malignant gliomas were grade 3,2 of them grade 2;among the remaining 16 cases,13 cases were grade 0 to 1,3 cases grade 2.Conclusions:Brain tumors are usually hyperechoic on TCCS images,presence of hypoechoic or aechoic regions exists in high grade malignant brain tumors.Power Doppler based on TCCS could well display blood supply within the tumors,significantly increase differential diagnostic rate between benign and malignant brain tumors.