超声造影评价肝结核瘤血流灌注特征的临床研究

Clinical study of hepatic tuberculosis perfusion by contrast-enhanced ultrasound

目的:采用实时超声造影观察肝结核瘤血流灌注特征,以探讨超声及超声造影对肝结核瘤的诊断价值。方法:对9例肝结核瘤(14个病灶)行常规超声检查后,再行超声造影检查,分析每一病灶造影动态增强特点,进行时间-强度曲线定量分析,获得开始强化时间及峰值时间。结果:14个肝结核瘤病灶常规超声均表现为低回声,超声造影动脉相增强均呈高强化,其中10个病灶呈环状强化,4个病灶呈弥漫性强化,强化的起始时间为12.30～16.80 s,平均(14.06±1.81)s,峰值时间为23.45～32.33 s,平均(27.62±2.38)s。所有病灶动脉相迅速强化至高峰后,逐渐消退持续至门脉相及延迟相,病灶呈低强化或无强化。结论:超声造影可动态显示肝结核瘤血流灌注特征,密切结合临床及病理,可提高肝结核瘤的诊断准确率。

Objective： To explore the characteristics of hepatic tuberculosis lesions by contrast-enhanced ultrasound. Methods： Nine patients with hepatic tuberculosis （fourteen lesions） were examined with conventional ultrasound and contrast-enhanced ultrasound. Dynamic enhancement of lesions was observed. Corresponding parameters such as time to enhancement （ET）,time to peak intensity （PIT） were measured by time-intensity curve. Results： All hepatic tuberculosis lesions were hypoechoie which demonstrated hyper-enhancement in arterial phase. Of fourteen lesions, ten lesions demonstrated circle periphery hyper-en- hancement and four lesions demonstrated whole hype-enhancement. The ET of hepatic tuberculosis was （14.06±1.81） s on average,ranging from 12.30 s to 16.80 s,and PIT was （27.62±2.38） s on average,ranging from 23.45 s to 32.3 s. All le- sions demonstrated hypo-enhanced or non-enhancement in portal phase and delayed phase after the peak enhancement in arterial phase. Conclusions： The study shows contrast-enhanced ultrasound could provide enough information of perfusion for hepatic tuberculosis. Combination of clinical and pathological findings adds to differential diagnosis of them.