超声造影在评估肝转移瘤血供中的价值：与增强 CT 的对照研究。

Value of contrast-enhanced ultrasonography in assessing the vascularity of liver metastases: comparison with contrast-enhanced computed tomography.

机构信息

Department of Medical Ultrasonics, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

J Ultrasound Med. 2010 Oct;29(10):1403-10. doi: 10.7863/jum.2010.29.10.1403.

DOI:10.7863/jum.2010.29.10.1403

PMID:20876893

Abstract

OBJECTIVE

The purpose of this study was to compare the capability of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computed tomography (CECT) in evaluating the vascularity of liver metastases.

METHODS

Both CEUS and CECT examinations were performed on 70 patients with liver metastases, which were from colon carcinoma in 31, rectal carcinoma in 17, pancreatic carcinoma in 5, and others in 17. In patients with multiple lesions, the most easily observed lesion was selected as the target lesion for evaluation of vascularity.

RESULTS

Peak enhancement of the target lesion during the arterial phase was characterized as hyperenhancement, isoenhancement, hypo-enhancement, and nonenhancement in 61 (87.1%), 6 (8.6%), 3 (4.3%), and 0 (0%) patients on CEUS, respectively, and in 52 (74.3%), 8 (11.4%), 8 (11.4%), and 2 (2.9%) on CECT. Contrast-enhanced ultrasonography showed more lesions with hyperenhancement than CECT (P < .01). The enhancement pattern during the arterial phase was homogeneous, inhomogeneous, and rimlike in 30 (42.9%), 16 (22.9%), and 24 (34.2%) patients on CEUS and in 13 (18.6%), 8 (11.4%), and 49 (70%) on CECT. Contrast-enhanced ultrasonography revealed more lesions with homogeneous enhancement than CECT (P < .01). Contrast-enhanced ultrasonography showed dysmorphic vessels in 33 patients (47.1%) during the arterial phase, whereas CECT showed dysmorphic vessels in 27 (38.6%; P < .01). Contrast-enhanced ultrasonography showed hypervascular lesions in 58.6% of patients, whereas CECT showed hypervascular lesions in 12.9% (P < .01).

CONCLUSIONS

Contrast-enhanced ultrasonography was superior to CECT in assessing the vascularity of liver metastases.

摘要

目的

本研究旨在比较超声造影（CEUS）和增强 CT（CECT）在评估肝转移瘤血供中的作用。

方法

对 70 例肝转移瘤患者分别行 CEUS 和 CECT 检查，其中结肠癌 31 例，直肠癌 17 例，胰腺癌 5 例，其他 17 例。对于多发病灶患者，选择最易观察到的病灶作为靶病灶进行血供评估。

结果

CEUS 动脉期靶病灶的峰值增强表现为高增强、等增强、低增强和无增强分别为 61 例（87.1%）、6 例（8.6%）、3 例（4.3%）和 0 例（0%），CECT 分别为 52 例（74.3%）、8 例（11.4%）、8 例（11.4%）和 2 例（2.9%）。CEUS 显示的高增强病灶多于 CECT（P＜0.01）。动脉期增强模式在 30 例（42.9%）和 16 例（22.9%）患者中表现为均匀，在 24 例（34.2%）和 13 例（18.6%）患者中表现为不均匀，在 49 例（70%）和 8 例（11.4%）患者中表现为边缘环形。CEUS 显示的均匀增强病灶多于 CECT（P＜0.01）。CEUS 在动脉期显示 33 例（47.1%）患者存在血管畸形，而 CECT 显示 27 例（38.6%）存在血管畸形（P＜0.01）。CEUS 显示 58.6%的患者为富血供病灶，而 CECT 显示为 12.9%（P＜0.01）。