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目的探讨超声造影对肝转移癌的诊断价值。方法对43例肝转移癌病灶(原发癌分别为腺癌32例,鳞癌9例,恶性间质细胞瘤1例,多发性骨髓瘤1例)行超声造影(CEUS)检查,观察其开始增强时间、动脉灌注特点及增强类型,并与其原发肿瘤的病理细胞类型比较。观察造影前、后动脉相病灶的血流变化,对血流进行分级比较。CEUS动脉相(0~40 s)、门脉相(41~120 s)观察病灶增强类型,延迟相(120 s以后)观察全肝病灶数目并与增强CT比较。结果CEUS动脉相肝转移癌Ⅲ~Ⅳ级血流的病灶数目较造影前明显增加(P<0.05);肝转移癌病灶动脉灌注、增强类型表现多样,与其原发肿瘤的病理细胞类型比较缺乏特异性;CEUS肝转移病灶增强类型不同于增强CT,且在延迟相较增强CT能发现更多新病灶。结论CEUS对肝转移癌具有重要诊断价值。
Objective To investigate the diagnostic value of contrast-enhanced ultrasound in the diagnosis of liver metastases. Methods 43 patients with metastatic liver cancer (primary adenocarcinoma were 32 cases, squamous carcinoma 9 cases, malignant stromal cell tumor 1 case, multiple myeloma 1 case) were examined by ultrasonography (CEUS) Enhance the time, the characteristics of arterial perfusion and the type of enhancement, and compared with the primary tumor pathological cell types. Observed before and after angiography arterial lesions of the blood flow changes, the blood flow for grading comparison. CEUS arterial phase (0-40 s) and portal phase (41-120 s) were used to observe the enhancement types of the lesion. The delayed phase (after 120 s) was used to observe the number of whole liver lesion and compare with enhanced CT. Results The number of lesions of grade Ⅲ ~ Ⅳ blood flow in CEUS arterial phase liver metastases was significantly increased (P <0.05) compared with those before the operation. The hepatic metastatic carcinoma lesions showed various arterial perfusion and enhancement types, which were different from those of the primary tumor ; CEUS liver metastases lesions enhanced type is different from enhanced CT, and in the delay compared to enhanced CT can find more new lesions. Conclusion CEUS has important diagnostic value for liver metastases.