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[肝转移瘤患者与健康对照者不同超声造影剂肝内渡越时间(HTT)的对比研究]

[A comparative study of the hepatic transit time (HTT) of different ultrasound contrast agents in patients with liver metastases and healthy controls].

作者信息

Haendl T, Strobel D, Neureiter D, Esser K, Frieser M, Hahn E G, Bernatik T

机构信息

Medizinische Klinik 1, Universitätskliniken Erlangen.

出版信息

Ultraschall Med. 2010 Dec;31(6):582-8. doi: 10.1055/s-0028-1109953. Epub 2010 Feb 24.

Abstract

PURPOSE

Liver metastases lead to a shortening of the HTT of an echo enhancer. Studies using SonoVue™ also showed a shortening of the HTT in healthy controls. Hence the HTT depends on the applied contrast agent. We examined whether the HTT of SonoVue™, Luminity™ und Levovist™ is useful to discriminate between patients with and without liver metastases.

MATERIALS AND METHODS

We compared the arteriovenous HTT of Levovist™, Sonovue™ und Luminity™ in 20 patients with liver metastases and in 15 controls. An Acuson Sequoia™ ultrasound system was used. The HTT results from the difference of the arrival time of the microbubbles in the hepatic artery and a hepatic vein.

RESULTS

Using Levovist™ six patients and three controls had to be excluded from further analysis. The arrival time was undetectable. The mean HTT values in healthy controls were: Levovsit™ 14.75 sec (SD ± 2.53 sec), SonoVue™ 9.27 sec (SD ± 2.41 sec) and Luminity™ 9.2 sec (SD ± 2.34 sec). In patients the mean HTT values were: Levovist™ 9.89 sec (SD ± 1.04 sec), SonoVue™ 6.28 sec (SD ± 2.41 sec) and Luminity™ 6.33 sec (SD ± 1.37 sec). Using a cut off of 8 sec for SonoVue™ and Luminity™, the sensitivity to exclude liver metastases was 75% and 80%.

CONCLUSION

The mean HTT values of all contrast agents were shorter in patients. Levovist™ showed a longer HTT in patients and controls than Luminity™ and SonoVue™. Levovist™ showed the best separation between patients and controls but some patients and controls had to be excluded. The HTT could still be a useful tool to exclude liver metastases but the HTT depends on the contrast agent and the applied contrast technique.

摘要

目的

肝转移会导致回声增强剂的肝循环时间(HTT)缩短。使用声诺维(SonoVue™)的研究也表明健康对照者的肝循环时间会缩短。因此,肝循环时间取决于所应用的造影剂。我们研究了声诺维(SonoVue™)、Luminity™和Levovist™的肝循环时间是否有助于鉴别有无肝转移的患者。

材料与方法

我们比较了20例肝转移患者和15例对照者中Levovist™、声诺维(Sonovue™)和Luminity™的动静脉肝循环时间。使用了Acuson Sequoia™超声系统。肝循环时间由微泡在肝动脉和肝静脉中到达时间的差值得出。

结果

使用Levovist™时,6例患者和3例对照者必须排除在进一步分析之外,因为无法检测到到达时间。健康对照者的平均肝循环时间值分别为:Levovsit™ 14.75秒(标准差±2.53秒),声诺维(SonoVue™)9.27秒(标准差±2.41秒),Luminity™ 9.2秒(标准差±2.34秒)。患者的平均肝循环时间值分别为:Levovist™ 9.89秒(标准差±1.04秒),声诺维(SonoVue™)6.28秒(标准差±2.41秒),Luminity™ 6.33秒(标准差±1.37秒)。将声诺维(SonoVue™)和Luminity™的截断值设定为8秒时,排除肝转移的敏感度分别为75%和80%。

结论

患者中所有造影剂的平均肝循环时间值均较短。与Luminity™和声诺维(SonoVue™)相比,Levovist™在患者和对照者中显示出更长的肝循环时间。Levovist™在患者和对照者之间显示出最佳的区分度,但一些患者和对照者必须被排除。肝循环时间仍可能是排除肝转移的有用工具,但肝循环时间取决于造影剂和所应用的造影技术。

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