感兴趣区的描绘对肝细胞肝癌超声造影灌注参数的影响

EFFECT OF THEINTERESTED REGION DEPICTION ON THE PERFUSION PARAMETERS OF CONTRAST ENHANCED ULTRASOUND IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

目的:探讨不同感兴趣区(ROI)描绘对肝细胞肝癌(HCC)超声造影(CEUS)灌注参数的影响。方法:对66例69个HCC病灶进行CEUS检查,利用Sonoliver绘制病灶时间——强度曲线(TIC)。按病灶的不同增强模式分均匀增强组和不均匀增强组,按不同位置分前场组、中场组、后场组。依次改变病灶ROI大小及形态,改变参考区的ROI大小及形态,以及改变参考区ROI深度,观察不同ROI的描绘对时间参数——上升时间(RT)、达峰时间(TTP)、平均渡越时间(MTT);强度参数——峰值强度(IMAX);共同参数——曲线下面积(AUC)的影响。结果:有60例63个HCC病灶获得满意的TIC。均匀增强组的病灶灌注参数变异度较不均匀增强组的小,不同深度的病灶变异度不同。参考区ROI的大小及形态、深度的改变对病灶时间参数无影响,仅对IMAX、AUC有影响。仅改变病灶或参考区ROI的大小及形态,除MTT外,余灌注参数变异较小。RT、TTP是最稳定的灌注参数。结论:CEUS定量分析病灶各灌注参数的稳定性受不同增强模式、不同位置的影响,因此不同病灶比较时应在同等条件下进行。同一病灶治疗前后比较应尽量保持ROI一致。

Objective：To explore the impaction of perfusion parameters using different regions of interest on contrast enhanced ultrasound （CEUS） of hepatocellular carcinoma （HCC）.Methods：CEUS and time intensity curve （TIC） were performed in 69 HCC lesions in 66 patients.The lesions were divided into homogenous,inhomogenous enhancement groups and close area,middle area,further area groups according to their enhancement patterns,positions respectively.The parameters of time parameters-rise time （RT）,time to peak （TTP）,mean transit time （MTT）,intensity parameter maximum intensity （IMAX） and combined parameter area under the curve （AUC） were analyzed.The influence of depth,size and shape of the region of interest （ROI） were also analyzed.Results：Sixty three HCC lesions in sixty patients received acceptable TIC.Variation of lesions＇ perfusion parameters was smaller in homogenous than in inhomogenous enhancement groups.Different variation was showed in different positions.If only changed the size and shape of ROI of lesions or reference areas,perfusion parameters showed little variations except MTT.RT and TTP were the most stable parameters.Conclusion：The perfusion parameters are affected by different enhancement patterns and positions of lesions,therefore,the same situations should be concerned in comparison among individuals.Same ROIs are best for the assessment of tumor response.