超声造影对脾实性占位性病变的诊断价值

Evaluation of contrast-enhanced ultrasonography in diagnosis of focal splenic solid lesions

目的探讨实时灰阶超声造影技术在脾实性占位性病变良恶性鉴别诊断中的价值。方法采用超声造影剂SonoVue对32例脾实性占位性病变进行超声造影检查（良恶性病灶各16例），实时动态地观察病灶的增强时相与增强方式。结果脾恶性病变组在增强时间上与良性组相比表现为“快退”特征，恶性病灶增强强度达高峰时及开始减退所用的时间分别为（19．7±4．5）s、（29．7±10．9）s，而良性病灶组造影时的相应时间分别为（24．2±4．4）s、（50．9±．9）s，恶性病灶造影剂开始减退时间较良性病灶快，差异有统计学意义（P〈0.05）。良恶性病灶在增强方式上的差异无统计学意义（P〉0．05）。超声造影能够发现更多的病灶，造影前共检出111个病灶，造影后共检出14210个病灶。结论超声造影有助于提高对脾实性占位性病变的诊断准确性。

Objective To investigate the value of contrast-enhanced ultrasonography （CEUS） for differential diagnosis of focal splenic solid lesions. Methods Thirty-two patients with 32 focal splenic lesions were examined with CEUS. The enhancement phases and perfusion were observed. Each group has 16 patients. Results The contrast media extincted more quickly in malignant lesions than in benign ones. The peak time and initial decreasing time of the malignant lesions were （ ] 9.7 ± 4.5 ） s and （29.7 ± 10.9） s. The opposite time of the benign lesions were （24. 2 ± 4. 4）s and （50. 9 ± 22.8）s. The initial decreasing time of the malignant lesions was earlier than that of the benign ones. The enhancement pattern was similar between the two groups. More lesions can be detected after CEUS. The number of the lesions was 111 before CEUS and 142 after CEUS. Conclusions CEUS is useful in the differential diagnosis of splenic lesions.