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目的应用低机械指数灰阶超声造影研究肝恶性肿瘤的动态期相性增强变化规律及其诊断价值。方法分别经耳缘静脉对8只荷VX2瘤新西兰大白兔团注超声造影剂SonoVue(0.1ml/kg),应用CnTI低机械指数实时造影匹配成像技术,动态观察兔VX2瘤及其周围肝实质造影增强效应。结果在所有造影过程中,肝肿瘤及肝实质内造影剂随时间呈动态增强。VX2瘤动脉期明显强化,呈“灯泡征”,与周围肝组织灰阶对比明显;随后造影剂逐渐退出,肿瘤回声强度从与周围肝实质持平,到低于周围肝实质,最后造影剂完全退出瘤组织,在肝实质增强的背景下呈极低回声。肿瘤强化呈“快进快出”型。结论VX2瘤主要为肝动脉供血,具有恶性肿瘤“快进快出”典型的超声造影增强特点;低机械指数灰阶超声造影能完全反映肝恶性肿瘤血流动力学变化;观察肿瘤的动脉期是超声造影的关键,对诊断及鉴别诊断具有重要意义。
Objective To evaluate the dynamic phase contrast enhancement and its diagnostic value of low-intensity gray-scale contrast-enhanced ultrasound in the diagnosis of hepatic malignancies. Methods 8 rabbits bearing VX2 New Zealand white rabbits were infused with ultrasound contrast agent SonoVue (0.1ml / kg) via the ear vein respectively. The CnTI low mechanical index real-time contrast-matched imaging technique was used to observe the dynamic changes of VX2 tumor and its surrounding liver parenchyma Enhance effect. Results During all the angiography, contrast medium in liver tumor and liver parenchyma increased dynamically with time. VX2 tumor artery phase was significantly enhanced, showed a “light bulb syndrome”, and the surrounding liver tissue grayscale contrast; followed by the gradual withdrawal of contrast agent, tumor echo intensity from the surrounding liver parenchyma, lower than the surrounding liver parenchyma, and finally the complete withdrawal of contrast agent Tumor tissue, very hypoechoic in the context of enhanced liver parenchyma. Tumor enhancement was “fast forward fast” type. Conclusions VX2 tumor is mainly for the hepatic artery, and has the characteristic of “fast-moving-fast-out” typical enhancement of contrast-enhanced ultrasound. Low mechanical index gray-scale contrast echocardiography can fully reflect the hemodynamic changes of liver malignant tumor. The arterial phase of the tumor is The key to contrast-enhanced ultrasound is important for diagnosis and differential diagnosis.