声学造影剂及二次谐波成象在肝癌诊断中的作用及局限性

The Potential of Sonographic Contrast Agent and Second Harmonic Imaging in the Diagnosis of HCC

目的：探讨微气泡型声学造影剂和二次谐波成象在肝癌诊断中的作用及局限性。方法：１３例肝癌病人经外周静 脉注射造影剂（剂量０．５～ １０ｍｌ）后检查。二次谐波成象用 １．７／３４ＭＨｚ（ＡＴＬ－ＨＤＩ ５０００）或１．８／３．６ＭＨｚ（ＨＰ ５５００）。结 果：肝动脉期肝脏多数无明显增强，少数病灶内出现斑点状回声增强，门静脉增强后肝组织才明显增强，但肿瘤组织 增强不明显。增强后有利于低回声病灶的显示而对高回声病灶或中高混杂回声病灶显示无益。增强后可显示更多 的瘤血管。结论：微气泡型声学造影剂及二次谐波成象反映的主要是肝组织总体供血量的变化，相对于正常肝组织 来说肝癌总是少血管的，谐波成象可以显示更多的血管。

Background/Aims: To evaluate microbubble based ultrasonic contrast agents and harmonic imaging in the diagnosis of liver tumor. Methods: The media (0.5 to 1.0ml) was injected into peripheral veins of 13 patients with hepatocellular caricnoma (HCC). Second harmonic imagings were performed with ATL-HDI 5000(1.7/3.4MHz) or HP 5500(1.8/3.6MHz). Results: Except some spot enhancement on the lesions of two cases, little enhancement could be noticed on liver at arterial phase. However, after portal veins were enhanced, the parenchyma of livers were enhanced obviously, but not of the tumors. Hypoechoic masses were well detected after administration of contrast agents. Hyperechoic masses and iso-hyperechoic masses were poorly detected. There were more vessels could be shown on harmonic imagings. Conclusions: Microbubble based agents and second harmonic imaging mainly reflect the hemodynamic of liver in general. HCC is always hypovascular in relation to the normal liver. Harmonic imaging improves the visualization of vessels.