经直肠超声造影诊断直肠癌的价值

目的 探讨经直肠超声造影对直肠癌的诊断价值.方法 21例直肠癌患者,常规超声观察病变二维声像图和彩色血流特点,超声造影观察病变组织内造影剂强化特点、增强时间、增强水平、增强形态及变化；对声像图进行定量分析,绘制肿瘤与正常肠壁的感兴趣区血流灌注的时间-强度曲线,并进行拟合,分析其峰值强度及达峰时间.结果 常规超声表现:直肠肠壁增厚,回声减低,边界不清,肿瘤内部回声不均,内部和周边可探及丰富的彩色血流信号,呈高速高阻血流频谱.超声造影表现:病灶呈快速高增强模式,与周围正常肠壁回声差异显著；可清楚显示病灶的大小、边界与侵袭范围；其肿瘤血管走行扭曲,形态不规则,并能够显示彩色多普勒超声不能显示的微血管.应用超声造影伪彩编码与叠加技术,有助于增强对肿瘤与周边正常组织关系的认识.与正常肠壁相比,肿瘤的达峰时间减小,达峰强度增加.结论 直肠癌超声造影具有典型的声像图表现,可以为直肠癌的术前诊断与术后评估监控提供更加丰富的信息.

Contrast enhanced ultrasound imaging of rectal cancer by endorectal ultrasound

Objective To quantitatively analyse the characteristics of ultrasonography images of colorectal cancer after contrast enhanced ultrasound examination. Methods Twenty -one rectal cancer patients were included for contrast ultrasound imaging. The characteristics of contrast enhanced ultrasound imaging of the rectal cancers were studied, including enhancement time, the intensity, the shape and the changes.The software Sonomath was used for the quantitative analysis for the tumors and the normal intestinal. The regions of interest were chosen and the perfusion time-intensity curves and fitting curves were depicted by Sonomath. The peak intensity(PI), time to peak(TP) and other parameters were calculated. Results The imaging of rectal cancers was quickly enhanced after the injection of ultrasound contrast agent and significantly different from that of surrounding normal bowel wall. Contrast enhanced ultrasound imaging could clearly show the rectal lesion size, border and invasion range. It also showed the irregular tortuosity of rectal lesion and tumor blood vessels and microvessels which could not be observed by the conventional color Doppler. The pseudo -color coded contrast ultrasound imaging which was overlayed to the 2D ultrasound imaging could help to confirm the relationship between the tumor and surrounding normal tissue. Compared with the normal intestinal, the TP in tumors decreased while the PI increased. Conclusion The contrast enhanced transrectal ultrasound imaging on rectal tumor has the typical sonographic characteristic, which could be able to provide rich information for the diagnosis and postoperative evaluation of rectal cancer.