论文部分内容阅读
目的探讨肝硬化背景下增生结节的超声造影模式及定量分析。方法对89例肝硬化背景下增生结节(18例)、不典型增生结节(30例)、小肝癌(41例)行超声造影检查并经病理结果证实,对比分析各类结节的超声造影三期增强模式、峰值强度(Peak%)、达峰时间(TTP)、平均渡越时间(MTT),将局部血容量(RBV)、局部血流量(RBF)根据增强时相分为动脉期RBV/RBF、门脉期RBV/RBF、延迟期RBV/RBF,进一步对比分析。结果增生结节造影模式呈三期等增强,不典型增生结节增强模式较为多样,小肝癌增强模式以快进快出为主。三类结节定量参数随病程进展Peak%逐渐增强、TTP及MTT逐渐缩短,而RBV、RBF在造影时相的动脉期、门脉期、延迟期具有动态变化,其特点分别与其各自的超声造影增强模式相对应。增生结节与不典型增生结节对比:造影模式动脉期、延迟期表现、延迟期RBF差异有统计学意义(P<0.05);增生结节与小肝癌对比:超声造影三期增强模式、Peak%、TTP、MTT、动脉期RBV、动脉期RBF、延迟期RBV、延迟期RBF差异有统计学意义(P<0.05);不典型增生结节与小肝癌对比:超声造影三期增强模式、定量参数Peak%、TTP、动脉期RBV、动脉期RBF差异均有统计学意义(P<0.05)。结论结合超声造影三期增强模式及超声造影定量参数,可以为肝硬化背景下增生结节、不典型增生结节、小肝癌的鉴别提供诊断依据。
Objective To investigate the mode of ultrasound contrast and quantitative analysis of hyperplastic nodules in cirrhotic liver. Methods Eighty-nine patients with proliferative nodules (18 cases), atypical hyperplastic nodules (30 cases) and small hepatocellular carcinoma (41 cases) under cirrhosis were examined by ultrasonography and confirmed by pathological results. Ultrasonography The third phase enhancement mode, Peak%, TTP, and MTT, divided the regional blood volume (RBV) and local blood flow (RBF) into arterial phase RBV / RBF, portal venous RBV / RBF, delay RBV / RBF, further comparative analysis. Results The hyperplasia of nodules was enhanced in three stages and the enhancement of atypical hyperplasia was more diverse. The mode of enhancement of small hepatocellular carcinoma was faster and faster. The quantitative parameters of three types of nodules gradually increased with the progress of the disease, TTP and MTT gradually shortened, while the RBV, RBF in the arterial phase, portal phase, delayed phase with dynamic changes, its characteristics were associated with their respective contrast-enhanced ultrasound Enhanced mode corresponds. Comparison of hyperplastic nodules and atypical hyperplasia nodules: The arterial phase, delayed phase and delayed phase RBF of the contrast model were statistically different (P <0.05); Comparison between the hyperplastic nodules and the small hepatocellular carcinoma: Contrast enhancement mode of ultrasound contrast, Peak %, TTP, MTT, arterial RBV, arterial RBF, delayed RBV, delayed RBF were statistically significant (P <0.05); atypical hyperplastic nodules and small hepatocellular carcinoma contrast: contrast enhanced ultrasound contrast mode, quantitative The parameters Peak%, TTP, arterial phase RBV, arterial phase RBF were statistically significant (P <0.05). Conclusions Combined with the three modes of contrast enhanced ultrasound and quantitative contrast echocardiography, it can provide a diagnostic basis for the identification of hyperplastic nodules, dysplastic nodules and small hepatocellular carcinoma in the context of cirrhosis.