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目的:探讨双重超声造影(DCUS)在诊断胃溃疡型病变中的价值。方法:选择经手术或胃镜病理证实的胃溃疡型病变50例,其中良性胃溃疡24例,溃疡型胃癌26例(局限溃疡型10例和浸润溃疡型16例);对照分析两组的DCUS影像资料,应用造影时间-强度曲线(TIC)参数对比造影剂开始增强时间(AT)、达峰时间(TTP)、峰值强度(PI)和增强强度(EI)。结果:DCEUS显示良性溃疡组胃壁呈低回声轻度增厚,伴较小范围凹陷,凹陷底部较平,壁层次结构清晰可辨。恶性溃疡组中局限溃疡型胃癌10例表现胃壁显著增厚,伴较大凹陷;浸润溃疡型胃癌16例显示胃壁广泛隆起增厚,伴一或数个凹陷,凹陷深大而窄。在经口服造影显示胃病灶解剖形态基础上,再行静脉造影进一步显示胃壁和病灶内部血流灌注,良性溃疡和恶性溃疡的特征区分更为显著。两组AT和TTP均差异不显著(P>0.05),良性溃疡组的PI、EI均显著低于恶性溃疡组(P<0.05)。结论:DCUS可显示良性胃溃疡和溃疡型胃癌的解剖形态及血流灌注特点,具有一定临床应用价值。
Objective: To investigate the value of double contrast echocardiography (DCUS) in the diagnosis of gastric ulcer type lesions. Methods: Forty gastric ulcer lesions confirmed by operation or endoscopy were included in this study. Among them, 24 cases were benign gastric ulcer and 26 cases were ulcerative gastric carcinoma (including 10 ulcerative ulcers and 16 infiltrative ulcers). The DCUS images Data were compared using contrast-time (TIC) parameters with contrast agent start time (AT), time to peak (TTP), peak intensity (PI) and intensity of enhancement (EI). Results: DCEUS showed mild hypoechoic thickening of the gastric wall in patients with benign ulcer, with a smaller area of depression, the bottom of the depression was flat, and the structure of the wall was clear and distinct. In gastric ulcer group, 10 cases of gastric ulcer type gastric cancer showed significant thickened, with larger depression; 16 cases of gastric ulcer type gastric ulcer gastric wall showed extensive uplift and thickening, with one or several depression, deep and narrow depression. On the basis of oral angiography showed that the anatomical pattern of gastric lesions, based on venography again further shows the gastric wall and lesion within the perfusion, the characteristics of benign and malignant ulcers more significant distinction. There was no significant difference in AT and TTP between the two groups (P> 0.05). The PI and EI in the benign ulcer group were significantly lower than those in the ulcer group (P <0.05). Conclusion: DCUS can show the anatomic morphology and perfusion characteristics of benign gastric ulcer and ulcerated gastric cancer, and has certain clinical value.