超声造影对肝内孤立性坏死性结节血流动力学的诊断分析

摘要

Objective To approach the application value of the contrast-enhanced ultrasonography(CEUS) in diagnosis of hemodynamics of intrahepatic solitary necrotic nodule(SNN). Methods Total 73 patients received from Jan. 2010 to Jan. 2014 had an resection operation and were confirmed pathologically as SNN in this hospital ,whose results both in conventional ul-trasound examination(CUE)and CEUS were analyzed. It is obtained some parameters such as arrived time,arrived intensity,time to peak,peak intensity,intensity changes,rising curve′s slope,transitting time from the time-intensity curve. Compared with nor-mal hepatic tissues at the same places,it will got corresponding parameters with statistical significance. In the end,the SNN diag-nosis accuracy between the CUE and CEUS were in comparison. Results Among them,62 focuses were described with non-clear agent perfusion in the arterial、portal and delayed phases on CEUS,8 lesions had peripheral circular enhancement in arterial phase. The resual 3 demonstrated a little enhancement. Compared to peripheral normal hepatic tissues ,it was significantly differ-ent in peak intensity,intensity changes and transit time(P<0.05). CEUS′s accuracy rate was higher than that of CUE(P<0.05). Conclusion CEUS is benefit to find out the characteristic rules of SNN′s hemodynamics and for the accuracy of diagnosis.%目的：探讨超声造影在诊断肝内孤立性坏死性结节（SNN）血流动力学中的应用价值。方法选择2010年1月至2014年1月在该院进行手术切除并经病理学证实为SNN的患者73例，对其常规超声和超声造影结果进行分析。超声造影从时间强度曲线中得到始增时间、始增强度、达峰时间、峰值强度、强度差值、上降支斜率、渡越时间，并与相应正常肝组织区域比较进行统计学分析。最后比较常规超声和超声造影诊断SNN的准确率。结果62例病灶在肝动脉相、门静脉相及延迟相中均无明显造影剂灌注；另有8例病灶边缘在动脉相有环状强化；余下3例病灶在动脉相及门静脉相有少许显影。SNN患者在峰值强度、强度差值及渡越时间3个参数上与周围正常肝组织比较，差异均有统计学意义（P＜0.05）。超声造影诊断SNN的准确率高于常规超声，差异有统计学意义（P＜0.05）。结论超声造影有助于发现SNN的血流动力学特征规律，对提高SNN的诊断准确率有一定帮助。