经周围静脉超声造影在肝内占位病变中的初步应用

Preliminary study of conrast enhanced ultrasound in the diagnosis of liver tumors

目的 探讨经周围静脉超声造影在肝癌诊断中的价值。方法 80例共 82个肝内占位性病变进行Levovist超声造影 ,浓度为 40 0mg/ml,注射时间约 2min。其中原发性肝癌 5 0个 ;转移性肝癌 1个 ;肝血管瘤12个 ;肝局灶性结节性增生 6个 ;肝脏炎性假瘤 5个 ,肝错构瘤 2个 ,其它良性病灶 6个。结果 有血供的肝内占位病灶均得到不同程度的增强 ,而肝癌达到明显增强者达 71% ,其阻力指数明显高于良性组 ,增强的峰值出现时间和持续时间均短于良性组。超声诊断肝肿瘤良恶性的符合率从 82 %提高到 98%。

Objective To assess the value of the contrast ultrasonography in the diagnosis of liver tumors. Methods Eighty patients with 82 hepatic solid lesions were examined by contrast ultrasonography. Of these, 50 lesions were hepatocellular carcinoma confirmed by pathology, 1 metastastic liver tumor, 12 hemangiomas, 5 inflammatory pseudotumors of liver, 2 hepatic hamartomas, 6 hepatic nodular hyperplasia and 6 other benign lesions. The Levovist with a concentration of 400 mg/ml was injected into an antecubital vein in apporximately 2 minutes. Results All hepatic lesions with hypervascularity were enhanced by contrast ultrasonography in varying degree. Marked enhancement was seen in 71% of hepatic cancer group, the mean resistive index was also much higher than benign lesion group. The peak enhancing time, peak persistent time were significantly shorter than those of the benign lesion benign. The accuracy rate of diagnosis of hepatic tumor increased from 82% in preenhancement to 98% in postenhancement. Conclusion The contrast enhanced ultrasonography is very useful in the differential diagnosis of liver tumors. (Shanghai Med J, 2000,23∶522 524)