动态灰阶超声造影在肝肿瘤诊断中的初步探索

Dynamic Grey Scale Enhanced Ultrasonography for Hepatic Tumors

目的 探讨动态灰阶超声造影在肝肿瘤诊断中的初步表现和作用。方法 选择 6例经手术和病理证实的肝内实质性占位病变进行灰阶超声造影和动态观察。造影剂选用Levovist,浓度为 40 0mg/ml,以团注形式经肘部浅静脉注入。结果 6例病人证实为原发性肝癌 2例 ,肝血管瘤 2例 (3个 ) ,肝脏局灶性结节性增生 1例 ,肝脏炎性假瘤 1例。除肝脏炎性假瘤外 ,其余病灶经造影后均有不同程度的增强。肝癌早期呈不均匀强化 ,消失较快 ;肝血管瘤增强速度较慢 ,呈周边强化 ;肝脏局灶性结节性增生亦早期增强 ,但维持较长时间。结论 动态灰阶超声造影对提高肝肿瘤的诊断有其实际意义。

Objective To evaluate the value of dynamic grey scale enhanced ultrasound in the diagnosis of hepatic tumors. Methods Six patients with 7 hepatic tumors were examined by dynamic enhanced ultrasound with a bolus injection of Levovist (400mg/ml). Results Seven lesions were confirmed by pathology and operation. Of them, There were 2 hepatocellular carcinomas (HCC), 3 hepatic hemangiomas (HCH), 1 focal nodular hyperplasia (FNH) and 1 inflammatory pseudotumor of liver (IPL). Six hepatic lesions were variously enhanced on ultrasonogram by injecting Levovist except for one IPL. The lesions with HCCs were earlier enhanced in the arterial phase and earlier disappeared in portal phase. The lesions with HCHs were enhanced late in arterial phase and in the peripheral region of the lesion. The FNH were earlier enhanced in arterial phase and disappeared slowly in portal phase. Conclusion The dynamic grey scale enhanced ultrasound is useful in the diagnosis of hepatic tumors.