虚拟导航超声造影与常规超声造影定位检测肝局灶性病变的比较

Virtual navigation assisted contrast-enhanced ultrasound for focal liver lesion invisible in B-mode ultrasound

目的比较虚拟导航超声造影与常规超声造影检出二维超声显示困难肝局灶性病变的差异，探讨虚拟导航超声造影的应用价值。方法47个CT或MR提示但二维超声无法显示的肝局灶性病变，分别行虚拟导航超声造影和常规超声造影，对比两种造影方法的病灶检出率。结果常规超声造影和虚拟导航超声造影的病灶检出率分别为36．2％（17／47）和78．7％（37／47），后者明显高于前者（P〈0．01）。虚拟导航超声造影时图像融合成功率达100％，平均对位用时5min。当病灶位于肝边缘受肋骨或肺气影响、肝实质背景杂乱及病灶异常灌注时相较短或灌注差异不明显时，虚拟导航超声造影比常规超声造影更容易定位并检出病灶。结论虚拟导航超声造影可明显提高二维超声无法显示肝局灶性病变的造影检出率。

Objective To evaluate virtual navigation assisted contrast-enhanced ultrasound （VN- CEUS） by comparing VN-CEUS with routine CEUS in detecting focal liver lesion（FLL） invisible in B-mode ultrasound（BUS）. Methods Forty-seven FLLs invisible in BUS were identified by CT/MR, and received VN-CEUS and routine CEUS respectively. Results The detection rate of VN-CEUS and routine CEUS were 78.7%（37/47） and 36. 2% （17/47）, the former was much higher than the later （P 〈0.01）. In all the cases,fusion of CT/MR with ultrasound was achieved successfully and average time for image fusion was 5 min. Compared with routine CEUS, VN-CEUS could more easily find FLLs shadowed by lung or ribs, FLLs in inhomogeneous liver background, and FLLs with brief or inapparent abnormal enhancement. Conclusions VN-CEUS can greatly improve the detection rate of FLL that was invisible in BUS.