目的:探讨超声造影参数成像在肝脏局灶性病变诊断中的应用价值.方法:运用SonoLiver CAP定量软件对88例接受超声造影检查的肝脏局灶性病变患者病灶进行定量分析,并以病灶与周围肝实质的增强水平差值为参数进行动态血管模型(dynamic vascular patterns,DVP)参数成像,比较良、恶性组间及其与周围肝实质定量参数及DVP有无差异.结果:定量参数包括:峰值强度、上升时间、达峰时间、平均渡越时间、灌注指数、上升斜率、下降斜率、峰值强度完全下降时间.我们把上升时间、达峰时间、灌注指数、上升斜率定义为灌注参数;平均渡越时间、下降斜率,峰值强度完全下降时间定义为消退参数.良、恶性间峰值强度比较差异无统计学意义(P=0.121);良、恶性组间灌注参数及消退参数比较差异均有统计学意义(P<0.05).在良性组中,峰值强度及灌注参数(除上升时间)与周围肝实质比较差异有统计学意义(P<0.05);而上升时间及消退参数与周围肝实质比较差异无统计学意义(P>0.05).在恶性组中,灌注参数及消退参数与周围肝实质比较差异均有统计学意义(P <0.05).在DVP曲线图中,良、恶性组消退型、未消退型及负向型分别占10%(4/40)、72.5%(29/40)、17.5%(7/40)和87.5%(42/48)、10.4%(5/48)、2.1%(1/48),两组比较差异有统计学意义(P<0.01);在DVP分布图中,良、恶性组消退型、未消退型及负向型分别占10%(4/40)、72.5%(29/40)、17.5%(7/40)和89.6%(43/48)、8.3%(4/48)、2.1%(1/48),两组比较差异有统计学意义(P<0.01).结论:超声造影参数成像可以更直观清晰地反映肝脏良恶性病灶与周围肝实质增强及消退水平的动态变化.
Objective:To investigate the usefulness of parametric imaging of contrast-enhanced ultrasound (CEUS) in evaluating focal liver lesions (FLLS).Methods:Eighty eight patients with FLLS undergone CEUS were divided into malignant (n 48) and benign (n 40) groups.SonoLiver CAP software was used to quantitatively analyze the CEUS parameters and reconstruct dynamic vascular patterns (DVP) parametric images.Results:The quantitative parameters included maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (MTT),perfusion index (PI),rising slope (RS),descending slope (DS),falling time of peak intensity (2MTT TTP).We defined RT,TTP,PI and RS as perfusion parameters while MTT,DS and 2MTT-TTP as fading parameters.There was no difference in IMAX between the benign and malignant groups (P =0.121),but there was significant difference in both perfusion parameters and fading parameters between the two groups (P 〈0.05).In benign group,there was significant difference in IMAX and perfusion parameters except the RT as compared with the surrounding liver parenchyma (P 〈0.05),but there was no significant difference in RT and fading parameters when compared with the surrounding liver parenchyma (P 〉0.05).In malignant group,there was significant difference in both perfusion parameters and fading parameters when compared with the surrounding liver parenchyma (P 〈 0.05).In DVP curve,the percentage of washout,non washout and cystic type were 10% (4/40),72.5% (29/40) and 17.5% (7/40) in benign group; and 87.5% (42/48),10.4% (5/48) and 2.1% (1/48) in malignant group,respectively; the difference was statistically significant (P〈0.01).In DVP parametric image,the percentage of washout,non-washout and cystic type were 10% (4/40),72.5% (29/40) and 17.5% (7/40) in benign group; and 89.6% (43/48),8.3% (4/48) and 2.1% (1/48) in malignant group,respectively; the difference was statistically si