肝细胞癌肝移植术后肝内复发灶的超声造影参数成像分析

Parametric imaging of contrast-enhanced ultrasound on recurrent hepatoceilular carcinoma after liver transplantation

目的探讨超声造影参数成像分析对肝细胞癌患者肝移植术后肝内复发灶的诊断价值。方法应用SonoLiverCAP定量软件对29例患者41个复发灶的超声造影资料进行定量分析，观察复发灶的动态血管模型（dynamic vascular patterns，DVP）彩色编码图、曲线图及定量参数，并进行分型及统计学分析。结果依DVP模式分为3型：消退型、未消退型及负向型。消退型、未消退型及负向型在DVP彩色编码图和曲线图上分别占70．73％（29／41）、24．39％（10／41）、4．88％（2／41）和63．41％（26／41）、34．15％（14／41）、2．44％（1／41）。定量参数分析：复发灶的峰值强度高于周围肝组织，上升时间、达峰时间快于周围肝组织，差异均有统计学意义（均P〈0．05）。结论超声造影参数成像分析可动态、直观、定量地反映复发灶与周围肝实质血流灌注的差异，参数成像分析为肝移植术后检测肝内复发灶提供了更为准确的信息。

Objective To explore the diagnostic value of parametric imaging of contrast-enhanced ultrasound（CEUS） on recurrent hepatocellular carcinoma after liver transplantation. Methods CEUS images of 41 recurrent hepatocellular carcinoma after liver transplantation was analyzed by Sonoliver CAP software. The color code image, curve image and quantitative parameter of DVP of each recurrence lesion was recorded,then typed and analyzed statistically. Results The DVP patterns were classified into 3 types, they were washed out types, non-washed out types and negative types. The washed out types, non-washed out types and negative types on color code image and curve image of DVP were 70.73 % （29/41）, 24.39 % （10/41）,4.88% （2/41） and 63.41%（26/41）,34.15% （14/41） and 2.44% （1/41） respectively. The maximum intensity,rise time, time to peak of the recurrence lesion and the surrounding liver parenchyma were （149.98± 65. 29）% , （12. 32 ± 5.83）s,（13.01 ± 6.07）s and （100 ± 0.00）%, （26.10 ± 10.81）s, （29.69 ± 11.60）s respectively, and showed statistical differences （ P〈0.05）. Conclusions The difference of blood perfusion between the recurrence lesion and the surrounding liver parenchyma can be displayed by DVP＇s dynamic,direct and quantitative imaging, which can be used to provide valuable information about the detection of intrahepatic lesion of recurrence after liver transplantation.