肝细胞性肝癌超声造影参数成像临床应用研究

Parametric imaging of contrast-enhanced ultrasound for hepatocellular carcinoma

目的 对肝细胞性肝癌（hepatocellular carcinoma,HCC）进行超声造影（contrast-enhanced ultrasound,CEUS）定量分析并进行动态血管模型（dynamic vascular patterns,DVP）参数成像的构建.方法 随机抽取30例接受CEUS检查并经临床或病理确诊的HCC患者,利用SonoLiver CAP定量软件对其进行定量分析;以HCC与周围肝实质的增强水平差值为参数进行DVP参数成像构建.结果 HCC的上升时间、达峰时间、平均渡越时间分别为（16.72±11.07）s、（29.92±14.13）s、（115.03±90.91）s,快于周围肝实质[分别为（26.59±9.60）s、（41.67±12.59）s、（159.26±1 23.74）s],差异均有统计学意义（均P〈0.05）;HCC的灌注指数为（90.41±102.49）%,高于周围肝实质的（54.10±24.99）%,差异有统计学意义（P=0.044）.HCC的DVP曲线和DVP分布图可分为三种类型：消退型、未消退型及负向型,这三种类型在DVP曲线分别占76.7%（23/30）、20.0%（6/30）及3.3%（1/30）,在DVP分布图分别占66.7%（20/30）、30.0%（9/30）及3.3%（1/30）.结论 超声造影参数成像可直观反映HCC与周围肝实质血流灌注的差异.

Objective To investigate the usefulness of parametric imaging of contrast-enhanced ultrasound（CEUS） in imaging hepatocellular carcinoma （HCC） using dynamic vascular patterns （DVP）. Methods Thirty clinically or pathologically proven HCCs that had undergone CEUS were randomly included. SonoLiver CAP sofeware was used to analyze the CEUS images and reconstruct DVP parametric images. Results The rise time, time to peak and mean transit time were （16. 72±11. 07） s, （29. 92±14. 13） s,（115. 03±90. 91）s in HCC versus （26. 59±9. 60） s, （41.67±12. 59） s, （159.26±123. 74） s in the surrounding liver parenchyma （all P 〈0. 05）. The perfusion index was （90. 41±102. 49） % in HCC versus （54. 10±24. 99）% in surrounding liver parenchyma（ P = 0.044）. DVP curve and DVP parametric image could both be divided into three types：washout,non-washout and cystic type. The percentages of which were 76.7% （23/30）, 20.0% （6/30） and 3.3% （1/30） in DVP curves, respectively, and 66.7% （20/30）, 30.0% （9/30） and 3.3% （1/30） in DVP parametric images,respectively. Conclusions Parametric image of CEUS could demonstrates the difference of flow perfusion static between HCC and surrounding liver parenchyma dynamically and directly.