SonoVue^(TM)低机械指数超声造影对肝肿瘤坏死的诊断价值

Contrast-enhanced ultrasonography with SonoVue^(TM) and low mechanical index gray-scale imaging in the diagnosis of liver tumor necrosis

目的应用SonoVueTM低机械指数灰阶超声造影研究肝肿瘤坏死的声像特点及其临床意义。方法将制备成功的16只荷VX2瘤新西兰大白兔随机分成A、B两组,分别于种植后10～12 d(A组)、18～20 d(B组)行低机械指数灰阶超声造影。经兔耳缘静脉团注超声造影剂SonoVueTM(0.1 mL/kg),应用CnTi(Contrast Tuned Ima-ging)低机械指数实时造影匹配成像技术,分析肝肿瘤坏死前后的造影增强效应。结果低机械指数灰阶超声造影可动态显示肝实质与肿瘤内造影剂的增强过程。与正常肝实质相比较,A组肿瘤强化呈典型的"快进快出"型,即动脉早期快速增强,门脉期与延迟期肿瘤结节内造影剂迅速廓清,表现为负性显影;B组肿瘤增强过程与A组相似,但由于瘤内有不同程度坏死,仅显示周边环状增强,而中心坏死部位无论在动脉期、门脉期及延迟期均无强化,无强化区域与病理的液化坏死区域对应一致。结论低机械指数灰阶超声造影可准确显示肿瘤的坏死范围,为其应用于评价肝癌局部治疗的疗效奠定了理论基础。

Objective To study the dynamic enhancement changes of necrosis of VX2 tumors with gray-scale contrast enhancement.Methods 16 VX2-bearing rabbits were randomly divided into group A and group B.SonoVueTM（0.1 mL /kg） was applied by intravenous bolus injection 10 to 12 days after implantation in group A and 18 to 20 days in group B.The contrast enhancement of liver tumors between the two groups was analyzed using low mechanical index contrast gray-scale imaging.Results Contrast-enhanced ultrasonography with low mechanical index（MI） gray-scale imaging clearly delineated dynamic enhancement of liver parenchyma and tumors.Compared with liver parenchyma,all tumors in group A showed hyperechoic enhancement in the arterial phase and hypoechoic enhancement in the portal and delayed phases.The enhancement of the tumors in group B was similar to that in group A.The necrotic area in the center of the tumors in group B showed hypoechoic enhancement in all phases,while the peripheral area without necrosis showed dynamic enhancement.Conclusions Contrast-enhanced ultrasonography with low MI level can accurately show the scope of tumor necrosis,which may be useful in evaluating curative effects on liver tumors.