白蛋白微气泡门静脉声学造影对肝癌血供的初步探讨

Study of portal vein blood supply for hepatic tumor by ultrasono portography using sonicated human albumin

目的探讨肝癌门静脉血供及门静脉声学造影临床应用价值。方法对２０例肝癌行超声引导下经皮经肝穿刺门静脉白蛋白微泡声学造影。结果肝癌肿块内出现造影剂者占７５％（１５／２０），较单纯彩色多普勒显像（ＣＤＩ）检出率（４５％）高，Ｐ＜０．０５；肿块内部造影剂明显充填者均为经肝动脉栓塞治疗后病例，且肿块直径多＞５．０ｃｍ；未经治疗的直径＜５．０ｃｍ肝癌，多呈现肿瘤局部低回声区域内出现偏心性局限性点、线状回声增强，伴肿块周边强回声带环绕。结论超声引导下经皮穿刺门静脉声学造影是研究肝肿瘤门静脉血供及其方式的安全灵敏方法。

Objective\ To investigate the pattern of hepatic tumor supplied by portal vein for liver cancer and the usefulness of ultrasono portography. Methods\ Sonicated 5% human albumin which was used as echo contrast agent(ECA) was injected into portal vein in 20 patients who presented with liver cancer by ultrasound guided percutaneously. Results\ There was 75%(15/20) of malignant hepatic tumous presented ECA intratumor. The rate was higher than that of color Doppler image(CDI) presented with portal vein flow signal(45%), P<0.05. Of 20 cases, obvious hyperechoic change intratumor after using ECA was presented in those patients who had been treated with transcatheter hepatic arterial embolization(TAE) and had the tumor size large over 5.0 cm in diameter mostly. Those malignant tumors without treated by TAE and with the diameter<5.0 cm presented focal spotty or linear hyperechoic change in hypoechoic tumor area with echo enhanced rim surrounding the tumor. Conclusions\ It is a safe and sensitive mathod to study portal vein blood supply for liver cancer with percutaneous ultrasound guided portography using sonicated 5% human albumin.