超声造影在膀胱占位性病变中的诊断价值

The application of contrast-enhanced ultrasound in the diagnosis of bladder occupied lesions

目的探讨超声造影在膀胱占位性病变中的诊断价值。方法 157例膀胱可疑占位性病变患者,共169个病灶结节,超声造影观测其造影剂灌注模式,病变造影时间-强度曲线的上升时间(RT)、达峰时间(TTP)和峰值强度(IMAX)。结果 116个膀胱癌病灶,96个表现为"快进慢退",呈高增强;16个表现为"快进快退",呈高增强;4个呈等增强。23个腺性膀胱炎病灶中,18个与周围正常膀胱壁同步增强和消退,5个表现为"快进慢退"。22个膀胱内血块和3个膀胱前壁混响伪像在造影过程中始终无增强。5个前列腺增生组织突入膀胱内,与前列腺组织同步增强和消退,无明显分界线。与自身膀胱壁比较,膀胱恶性肿瘤RT、TTP缩短,IMAX增强(P<0.05)。对膀胱占位性病变诊断准确率,常规超声为85.8%,超声造影为97.0%。结论超声造影可为膀胱占位性病变的鉴别诊断提供强有力的依据。

Objective To explore the value of contrast-enhanced ultrasound （CEUS） in the diagosis bladder occupied lesions. Methods One hundred and fifty-seven patients with 169 bladder occupied lesions were examined by CEUS after injecting SonoVue via the elbow vein. The time intensity curve（RT）, time to peak（TTP） and maximum intensity（IMAX） were observed. Results In 169 bladder occupied lesions, 116 of them were bladder carcinomas, 22 lesions of gore, 23 lesions of cystitis glandularis, 5 lesions of hyperplasia of prostate gland, and 3 lesions of reverberations artifact. In 116 bladder occupied lesions, 96 of them showed the characteristics of contrast agent ＂fast wash-in and slow wash-out＇, but 16 of them shower＂fast wash-in and fast wash-out＂, the rest of them presented the similar enhancement as the bladder wall. In 23 cystitis glandularis, 18 of them showed the similar enhancement as the bladder wall, but 5 of them showed ＂fast wash-in and slow wash-out＂. Twenty two lesions of gore and 3 lesions of reverberations artifact showed no enhancement during the CEUS. The accuracity was 85.8% in conventional uhrasonography and 97.0% in CEUS. Conclusion CEUS provides a powerful basis for the discrimination diagnosis of the bladder occupied lesions.