肝肿瘤实时灰阶谐波超声造影与彩色多普勒超声造影比较研究

Comparison of SonoVue-enhanced harmonic gray-scale and fundamental color Doppler US in detecting vascularity in liver lesions

的 比较实时灰阶谐波超声造影与彩色多普勒超声造影在评价肝肿瘤血供情况中的价值。方法 对 3 2例患者进行彩色多普勒超声造影和实时灰阶谐波超声造影,其中恶性肿瘤 19例(原发性肝癌 17例,转移性肝癌 2例),肝血管瘤 5例,局灶结节性增生 5例,肝硬化结节 1例,局灶性脂肪分布不均 2例。比较两种方法反映肝肿瘤血供情况的能力,与病理及动态增强CT对照。结果 彩色多普勒超声造影和实时灰阶谐波超声造影对血流的显示率分别为 90.7% (2 9/3 2),10 0 % (3 2/3 2 ),两种方法在判断肿瘤有无血供方面无明显差异。两种方法均可观察肿瘤增强的时相变化,实时灰阶谐波超声造影对肝实质内微血管血供的显示优于彩色多普勒成像,可判断肿瘤的坏死情况。结论 实时灰阶谐波超声造影可有效的显示肿瘤内的血供,并可动态观察肿瘤的血流灌注情况,其效果明显优于彩色多普勒超声造影。

Objective To compare the ability of two continuous US scanning modes, fundamental color Doppler (FCD) and harmonic gray-scale (HGS) ultrasonography in evaluating the vascularity of focal liver masses when enhanced with SonoVue. Methods SonoVue-enhanced fundamental color Doppler ultrasonography and harmonic gray-scale ultrasonography were performed on 32 patients with 32 focal hepatic lesions,which included 19 liver malignant tumors (MT), five hepatic hemangiomas (HCH), five focal nodular hyperplasias (FNH), one cirrhotic nodule, and two focal fatty sparing, a single lesion in each patient was imaged using both modes.These two modes were compared of its ability to depict vascularity within the lesion.Pathologic analysis and contrast-enhanced dynamic CT were performed as reference standard. Results Harmonic gray-scale ultrasonography is superior to fundamental color Doppler ultrasonography in depicting the parenchymal flow when enhanced with SonoVue. Both modes can show the time-intensity changes of different focal liver lesions. Conclusion SonoVue-enhanced real-time harmonic gray-scale ultrasonography appears superior to conventional Doppler ultrasonography in assessing focal liver lesion vasularity.