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目的通过对比四维和二维超声造影对肝肿瘤显示及诊断的异同,探讨四维超声造影对肝肿瘤诊断的临床价值。方法对17例(19个病灶)肝肿瘤患者先后进行二维和四维超声造影,经肘静脉注射超声造影剂SonoVue后观察肿瘤形态、灌注方式及滋养血管的特征。对比总结肝肿瘤四维超声造影的表现,分析其对肝肿瘤诊断的价值。结果二维和四维超声造影均显示原发性肝癌强化方式呈“快进快出”;肝转移瘤稍晚动脉期周边增强,而在门脉期和延迟期无强化;肝血管瘤呈“慢进慢出”;原发性肝癌射频治疗术后病灶三期均无明显强化,四维超声造影图像上呈“空洞样”。四维超声造影时可更清晰地动态显示肝肿瘤立体形态,且动态显示的肝肿瘤滋养血管条数及其分支明显增多、分布更加密集。结论四维超声造影图像立体感、层次感更强,能动态、连续显示肝肿瘤灌注及其滋养血管特征,可作为一种辅助肝肿瘤诊断的新方法。
Objective To compare the four-dimensional and two-dimensional contrast echocardiography of liver tumor display and diagnosis of similarities and differences, to explore four-dimensional contrast-enhanced ultrasound in the diagnosis of liver tumor clinical value. Methods Seventeen patients (19 lesions) with liver cancer underwent two-dimensional and four-dimensional contrast echocardiography successively. SonoVue was injected into the elbow vein to observe the morphology, perfusion pattern and nourishing vessel characteristics. To compare the performance of four-dimensional contrast-enhanced ultrasound in liver tumor and analyze its value in the diagnosis of liver tumor. Results Two-dimensional and four-dimensional contrast-enhanced ultrasound showed that the enhancement mode of primary liver cancer was “fast-forward and fast-out”. Liver metastases slightly increased in peripheral arterial phase and no enhancement in portal phase and delayed phase. “Slow into slow ”; primary liver cancer after radiofrequency treatment of lesions were not significantly enhanced in the third phase, four-dimensional contrast-enhanced ultrasound was “empty like.” Four-dimensional ultrasound contrast can be more clearly displayed dynamic three-dimensional morphology of liver tumors, and dynamic display of liver tumor nourish the number of blood vessels and its branches significantly increased, more densely distributed. Conclusion The four-dimensional contrast-enhanced ultrasound imaging has a stronger sense of three-dimensional structure and more layering. It can dynamically and continuously display the characteristics of hepatic tumor perfusion and nourishing blood vessels, and can be used as a new method to assist the diagnosis of liver tumors.