彩色多普勒超声造影诊断肝内小占位性病变的临床研究

目的　研究经周围静脉彩色多普勒超声造影在肝内小占位性病变的鉴别诊断中的作用和意义。方法　选择 <3cm的肝内占位性病变 5 4个进行超声造影检查。其中良性病变 2 0个 (血管瘤 9个 ,局灶性结节性增生 3个 ,炎性假瘤 4个 ,术后疤痕 1个 ,肝硬化结节 3个 ) ;恶性病变 3 4个 (肝细胞肝癌 3 1个 ,肝腺瘤样增生癌变 1个 ,胃癌及结肠癌肝转移各 1个 )。造影剂采用Levovist ,剂量 2 .5g ,浓度 40 0mg/ml。结果　良性病变造影前后血流显示率分别为 3 0 % (6/2 0 )和 40 % (8/2 0 ) (P >0 .0 5 ) ;肝癌造影前后血流显示率分别为 5 3 % (18/3 4)和 94% (3 2 /3 4) (P <0 .0 1) ,造影后血流显示明显提高。结论　Levovist造影后 ,肝内病灶血流信号得到明显增强 ,彩色多普勒血流显像充分显示了肿瘤内血流分布状况 ,有利于克服肿瘤大小及深度对血流显示率的影响 ,提高小肝癌的诊断符合率

Contrast-enhanced color Doppler ultrasonography of small hepatic lesions

Objective To investigate the effects of the contrast enhanced color Doppler ultrasonography in the diagnosis of small liver lesions. Methods Fifty four patients with hepatic lesions smaller than 3 cm were examined by contrast enhanced color Doppler ultrasonography. The pathologic diagnoses of these 54 lesions includes 20 benign lesions (hemangioma 9, focal nodular hyperplasia 3, inflammatory pseudotumor 4, postoperative scar 1, cirrhotic nodule 3) and 34 malignant ones (hepatocellular carcinoma 31, adenomatous hyperplasia with carcinoma foci 1, metastatic lesions of gastric and colon carcinoma respectively 1). The dosage of Levovist was 2.5 g with the concentration 400 mg/ml. Results The blood flow detection rates before and after Levovist administration in the benign lesions were 30%(6/20) and 40%(8/20) separatively(P> 0.05 ), those in the malignant group were 53%(18/34) and 94%(32/34) with a distinguished improvement after enhancement(P< 0.01 ). Conclusions Contrast enhanced color Doppler can improve the intratumoral blood flow signals and demonstrate fully the blood distribution in tumors, which raises the accurate diagnosis of small hepatocellular carcinoma.