动态血管模式曲线在腹膜后恶性肿块超声造影中的应用价值

Application value of contrast-enhanced ultrasound in retroperitoneal tumors diagnosis using dynamic vascular pattern curve

目的分析腹膜后良恶性肿块的超声造影指标的差异性及动态血管模式曲线特征,为腹膜后肿块的鉴别诊断提供依据。方法对52例腹膜后肿块患者(良性组26例,恶性组26例)行超声造影检查,使用SonoLiver造影软件分析图像,获得时间-强度曲线(TIC)和动态血管模式曲线(DVP),比较两组病灶区的达峰时间(TTP)、最大相对强度(IMAX)及病灶区与参考区的达峰时间差(ΔTTP)、强度差(ΔE)、拟合度(QOF)等指标;分析恶性组内动态血管模式曲线的形态特征及其与最大相对强度的关系。结果①良性组TTP(38.3±21.7)s大于恶性组TTP(26.6±10.3)s,良性组ΔTTP(12.2±16.8)s大于恶性组ΔTTP(-11.0±15.2)s,良性组IMAX(162.1±110.8)%小于恶性组IMAX(297.6±173.4)%,差异均有统计学意义(均P﹤0.05);两组间ΔE和QOF比较差异均无统计学意义;②恶性组动态血管模式曲线包括正性单向波13例、正负双向波9例及负性单向波4例;③正性单向波的IMAX为(208.6±86.5)%,正负双向波的IMAX为(123.4±43.5)%,两者比较差异有统计学意义(P=0.013)。结论超声造影病灶区与参考区的强度变化过程可为鉴别腹膜后肿块提供重要诊断依据。

Objective To study the feasibility of identifying diagnosis of retroperitoneal tumors using the contrast enhanced ultrasound （CEUS） through dynamic vascular pattern curve （DVPC） and the difference of ultrasonographic characters between malignant and benign tumors. Methods CEUS were performed for fiftytwo patients with retroperitoneal tumors （26 cases in malignant group and 26 cases in benign group）. SonoLiver software was used to analyze the data. Parameters such as the time intensity curve （TIC）, the dynamic vascular pattern（DVP）, time to peak（TrP）,the maximum intensity （IMAX）, the dynamic time to peak （TTP）, the dynamic enhancement （AE）and the quantity of fitting （QOF）were analyzed by the software. Results @The TTP, the ATI＇P and the IMX in the benign group via that of the malignant group were [TIP （38.3±21.7）s via （26.6±10.3）s,ATl＇P （12.2±16.8）s via （ll.0±15.2）s,IMAX （162.1±110.8）% via （297.6±173.4）%, respectively. The difference between the malignant and the benign group was significant （P 〈 0.05）.No difference of AE and QOF were found between the two groups.@Three types of malignant group DVPC including 13 cases of positive single wave, 9 cases of negative single wave and 4 cases of positivenegative wave. @The IMAX of the positive single wave （208.6±86.5）% and positive negative wave （ 123.4±43.5 ）% was significantly different （P=0.013）. Conclusion The CEUS is feasible to be used to identify diagnose the retroperitoneal tumors.