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目的 应用经静脉二次谐波声学造影方法探讨转移性肝癌血供特点。方法 3 5例患者共 79个转移性肝癌结节进行经静脉二次谐波声学造影检查。间歇成像由心电图R波触发 ,触发间隔为 1～ 3个心动周期。声学造影剂经左前臂静脉“弹丸式”注射。结果 注射造影剂后 15～ 18s[平均 (16.8± 1.5 )s]肝组织显影。肝动脉相 ,肿块区域早于周围肝组织 1～ 2个心动周期显影 ,造影剂迅速充盈 ,呈“淹没征”。增强效果 :I级 2 1个 ,II级 42个 ,III级 16个。 13个直径 >3 .0cm的瘤体内均有“蜘蛛网”样异常血管结构 ,66个直径 <3 .0cm瘤体中仅 15个显示“蜘蛛网”样血管。动态观察 ,肿块区域造影剂早于周围肝组织 10～ 15个心动周期消退。延迟成像 ,肝实质与瘤体回声对比度增大。结论 二次谐波声学造影是检测低速血流的敏感方法 ,有助于了解转移性肝癌的血供状况 ,对其诊断或鉴别诊断也有一定价值
Objective To investigate the characteristics of blood supply of metastatic liver cancer by intravenous second harmonic acoustic imaging. Methods 35 patients with a total of 79 metastatic liver cancer nodules by venous second harmonic contrast echocardiography. Intermittent imaging is triggered by the R wave of the electrocardiogram, triggering intervals of 1 to 3 cardiac cycles. Acoustic contrast agent by the left forearm vein “bolus injection. Results After injection of contrast agent 15 ~ 18s [mean (16.8 ± 1.5) s] liver tissue development. Hepatic artery phase, tumor area earlier than the surrounding liver tissue 1 to 2 cardiac cycle imaging, contrast agent filled quickly, was ”submerged sign.“ Enhancement: I Level 2 1, Level II 42, Level III 16. Thirteen tumors> 3.0 cm in diameter had ”cobweb“ -like abnormal vascular structures, and only 15 of 66 tumors <3 cm in diameter showed ”cobweb" -like vessels. Dynamic observation, lump area contrast agent earlier than the surrounding liver tissue 10 to 15 cardiac cycles subsided. Delayed imaging, liver parenchyma and tumor echo contrast increased. Conclusions Second harmonic contrast echocardiography is a sensitive method to detect low-velocity blood flow and is helpful to understand the blood supply status of metastatic liver cancer. It also has some value in its diagnosis or differential diagnosis