超声造影中肝脏占位性病变中的图像特征及诊断价值

Image features and diagnostic value of contrast-enhanced ultrasonography in hepatic space-occupying lesions

目的:研究超声造影(CEUS)中肝脏占位性病变中的图像特征及诊断价值。方法:回顾性分析90例肝脏占位性病变患者临床资料,分析患者的影像学图像特征和CEUS的诊断价值。结果:CEUS图像显示,肝脏占位性病变患者中良性病灶动脉期周边不连续的环状强化,门脉期和延迟期具有部分或完全的向心性充盈;恶性病灶动脉期增强早于邻近正常组织,呈现均匀或不均匀高增强;CEUS诊断准确率高于常规超声(P<0.05);恶性病灶者的始增时间、始消时间、持续时间均低于良性病灶者(P<0.05)。恶性病灶者的造影剂到达时间、峰值强度高于良性病灶者,达峰时间、拟合曲线尖度低于良性病灶者(P<0.05);CEUS定量参数联合鉴别诊断肝脏占位性病变的曲线下面积和敏感度均高于单一参数诊断(P<0.05)。结论:CEUS在肝脏占位性病变中的诊断价值价较高,可通过图像特征、动态时相变化及造影剂的时间-强度曲线参数为其良恶性鉴别提供参考。

Objective:Objective:To study the image features and diagnostic value of contrast-enhanced ultrasonography(CEUS)in hepatic space-occupying lesions.Methods:The clinical data of 90 patients with hepatic space-occupying lesions was retrospectively analyzed.The image features and diagnostic value of CEUS were analyzed.Results:CEUS images of benign lesions in patients with hepatic space-occupying lesions showed peripheral discontinuous annular enhancement in arterial phase,and partial or complete concentric filling in portal and delayed phases.Images of malignant lesions showed enhancement in arterial phase earlier than adjacent tissues,showed homogeneous or heterogeneous high enhancement.The diagnostic accuracy of CEUS was higher than that of conventional ultrasound(P<0.05).The arrival time,washing-out time and duration of patients with malignant lesions were shorter than those of patients with benign lesions(P<0.05).The arrival time and peak intensity of contrast agent in patients with malignant lesions were longer/higher than those in patients with benign lesions.The time to peak and the sharpness of the fit curve were shorter/lower than those in patients with benign lesions(P<0.05).The area under the curve and sensitivity of quantitative parameters of CEUS in combination to diagnose hepatic space-occupying lesions were higher than those of single parameter diagnosis(P<0.05).Conclusion:CEUS is helpful for the diagnosis of hepatic space-occupying lesions.It provides reference for differential diagnosis of begin and malignant hepatic space-occupying lesions through image features,dynamic phase changes,and time-intensity curve of contrast agent.