Bang N, Nielsen M B, Rasmussen A N, Osterhammel P A, Pedersen J F
Department of Radiology, Rigshospitalet, University of Copenhagen, Denmark.
Br J Radiol. 2001 Aug;74(884):752-5. doi: 10.1259/bjr.74.884.740752.
The aim of this study was to ascertain whether a new ultrasound technique, namely pulse inversion imaging, could assess the arrival of a contrast agent in the hepatic veins, and to describe possible advantages of this procedure in determining transit time over a previously described method based upon spectral Doppler quantification. 15 subjects were scanned using pulse inversion imaging. A bolus injection of 2.5 g Levovist (Schering AG, Berlin, Germany) 300 mg x ml(-1) was given into an antecubital vein. Median transit times of 16 s (range 14-20 s) were found in patients with liver cirrhosis (n=4), 22 s (range 16-27 s) in patients with focal liver lesions (n=8) and 31 s (range 30-32 s) in control subjects (n=3). The maximum interobserver variation was 2 s and the maximum intraobserver variation was 3 s (n=10). Transit time was assessed by both pulse inversion imaging and spectral Doppler quantification in six patients. Comparison of the two methods showed transit times within 2 s apart in five patients and within 5 s apart in one patient. In conclusion, it is possible to assess transit time using pulse inversion imaging. This method is simpler than a previously described method requiring computer analysis. Moreover, several liver veins can be assessed simultaneously. Different transit times were observed in different liver veins in two patients with liver tumours. A short transit time (<27 s) appears to be found only in patients with liver disease. After transit time assessment, it is possible to use the injected contrast agent for late phase imaging of the liver parenchyma.
本研究的目的是确定一种新的超声技术，即脉冲反转成像，是否能够评估造影剂在肝静脉中的到达情况，并描述该方法在确定通过时间方面相对于先前基于频谱多普勒定量描述的方法可能具有的优势。使用脉冲反转成像对15名受试者进行扫描。将2.5克Levovist（德国柏林先灵公司，300毫克/毫升）经肘前静脉团注。肝硬化患者（n = 4）的平均通过时间为16秒（范围14 - 20秒），肝局灶性病变患者（n = 8）为22秒（范围16 - 27秒），对照受试者（n = 3）为31秒（范围30 - 32秒）。观察者间最大差异为2秒，观察者内最大差异为3秒（n = 10）。对6名患者同时采用脉冲反转成像和频谱多普勒定量评估通过时间。两种方法的比较显示，5名患者的通过时间相差在2秒以内，1名患者相差在5秒以内。总之，使用脉冲反转成像评估通过时间是可行的。该方法比先前描述的需要计算机分析的方法更简单。此外，可同时评估多条肝静脉。两名肝肿瘤患者的不同肝静脉观察到不同的通过时间。短通过时间（<27秒）似乎仅在肝病患者中出现。通过时间评估后，可将注入的造影剂用于肝实质的延迟期成像。
