超声造影评价兔肝炎性假瘤及VX2肝癌血流灌注的实验对照研究

目的 应用实时超声造影成像技术及时间-强度曲线,观察兔肝炎性假瘤和转移性VX2肝癌的血流灌注方式.方法 荷炎性假瘤和荷VX2肝癌实验兔各10只,经耳缘静脉团注法注射超声造影剂SonoVue后,应用CnTI低机械指数实时灰阶成像技术和定量时间-强度曲线(Wash in-Wash out Curve)软件,观察分析各时相肿瘤结节及周围正常肝组织的动态增强过程.结果 与正常肝实质相比较,炎性假瘤造影增强与肝实质同步,二者造影始增时间、峰值时间、增强时间、始消时间无显著性差别(P>0.05).VX2肝癌强化呈典型的"快进快出"型,早期动脉相快速增强,门脉相与延迟相肿瘤结节内造影剂迅速廓清,表现为负性显影,VX2肝癌始增时间、峰值时间、增强时间、始消时间显著早于正常肝实质(P<0.05).VX2肝癌与炎性假瘤比较,VX2肝癌造影始增时间、峰值时间、始消时间显著早于炎性假瘤(P<0.05).结论 低机械指数实时超声造影成像,可提供肝脏局灶性结节的动态血流灌注信息,结合时间-强度曲线定量分析,对肝肿瘤的诊断和鉴别诊断具有较佳的实用价值.

Control study of hepatic inflammatory pseudoneoplasm and VX2 carcinoma perfusion in rabbits by contrast-enhanced ultrasonography

Objective To analysis the perfusion of hepatic inflammatory pseudoneoplasm (IPL) and VX2 carcinoma in rabbits by real-time contrast-enhanced ultrasound and time intensity curve. Methods Ten rabbits with IPL and 10 rabbits with VX2 carcinoma were studied by low mechanical index (MI) contrast-enhanced ultrasound with bolus injection of SonoVue via peripheral vein respectively. Corresponding parameters such as time to enhancement (ET), time to peak intensity (PIT), time to ascent (AT) and time to lighten (LT) were measured by CnTI (contrast tuned imaging) technique and time intensity curve. Results Real-time contrast-enhanced imaging clearly delineated the dynamic enhancement of the tumors and liver parenchyma during the whole phase. IPL showed the same enhanced features as that of liver parenchyma. There was no significant difference for ET, PIT, AT and LT between IPL and parenchyma (P>0.05). VX2 tumors showed hyperechoic enhancement in arterial phase and hypoechoic enhancement was observed in the portal and delayed phase compared to the hepatic parenchyma around the tumor lesions. The ET, PIT and LT were significantly earlier and the AT significantly shorter in VX2 carcinoma than those of the liver parenchyma (P<0.05). The ET, PIT and LT of IPL were significantly later than those of VX2 tumors (P<0.05). Conclusion Low mechanical index contrast-enhanced ultrasound provided enough information of perfusion for VX2 carcinoma and IPL. Real-time contrast-enhanced ultrasound is a useful technique in differential diagnosis of hepatic focal lesions combined with time intensity curve.