Kim Eun-A, Yoon Kwon-Ha, Lee Young Hwan, Kim Hye Won, Juhng Seon Kwan, Won Jong Jin
Department of Radiology and Institute of Medical Science, Wonkwang University School of Medicine, Jeonbuk, Korea.
Korean J Radiol. 2003 Oct-Dec;4(4):224-33. doi: 10.3348/kjr.2003.4.4.224.
To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect.
We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns.
Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively.
Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.
分析局灶性肝病变的脉冲反转谐波成像（PIHI）所获得的对比增强模式，从而确定肿瘤血管情况和声发射效应。
我们回顾了90例连续患有局灶性肝病变的患者的脉冲反转图像，这些病变包括肝细胞癌（HCC）（n = 43）、转移瘤（n = 30）和血管瘤（n = 17）。在注射微泡造影剂后立即及五分钟后获取血管期和延迟期图像。血管期成像的肿瘤血管情况和延迟期成像的声发射效应均分为四种模式之一。
血管期图像显示，93%的HCC有内部血管，83%的转移瘤有边缘血管，71%的血管瘤有周边结节状增强。延迟期图像显示，86%的HCC有不均匀增强；93%的转移瘤呈低回声、增强减弱；65%的血管瘤呈低回声且回声反转。血管期和延迟期增强模式的特异性分别为91%或更高和92%或更高，阳性预测值分别为71%或更高和85%或更高。
PIHI中描绘肿瘤血管情况和声发射效应的对比增强模式有助于鉴别局灶性肝病变。
