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应用高频超声造影评价浅表病灶微循环灌注的缺陷及初步解决方案
章建全
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(第二军医大学长征医院超声诊疗科, 上海 200003)

摘要:

目的：应用低、高频超声造影对比观察浅表病灶微循环灌注程度，探讨应用高频超声造影评价浅表病灶微循环灌注程度的缺陷并提出初步解决方案。方法：采用自身对照，先后应用低频、高频超声造影观察腮腺多形性腺瘤（1例）、甲状腺腺瘤（3例）、甲状腺癌（5例）、颈部转移癌（5例）、乳腺癌（7例）、睾丸精原细胞瘤（2例）等6种23例浅表病灶，利用ACQ软件对配对的低、高频造影声像图的峰值强度（PI）进行配对t检验分析。结果：6种浅表病灶（腮腺腺瘤、甲状腺腺瘤、甲状腺癌、颈部转移癌、乳腺癌及睾丸精原细胞瘤）微循环灌注强度的高频超声造影PI值均显著低于低频超声造影，差异有统计学意义（P<0.001）。结论：应用高频超声造影评价浅表病灶的微循环灌注强度可能低于其真实强度，临床上可在高频超声观察完浅表病灶的形态和内部结构后，改用低频超声造影评价其微循环灌注状态。

关键词: 肿瘤浅表病灶高频超声造影低频超声造影 SonoVue

DOI：10.3724/SP.J.1008.2007.01193

投稿时间：2007-02-25

基金项目:第二军医大学长征医院“三重三优”学科和人才建设专项基金

High-frequency contrast-enhanced ultrasound in evaluating perfusion of superficial lesions:limitations and countermeasures

ZHANG Jian-quan

(Department of Ultrasound Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China)

Abstract:

Objective：To evaluate the perfusion defect of superficial lesions by highfrequency contrastenhanced ultrasound through comparing the results of lowfrequency and highfrequency contrastenhanced ultrasound, and to put forward the preliminary countermeasures. Methods: Twentythree patients (9 male and 14 female, aged 45.87±9.32 years, ranging 3473 years) with 6 sorts of superficial lesions, including 1 parotid pleomorphic adenoma, 3 thyroid adenomas, 5 thyroid adenocarcinomas, 5 cervical metastases, 7 breast carcinomas and 2 of testicular seminomas, were examined by both lowfrequency and highfrequency contrastenhanced ultrasounds. CEUS with SonoVue under CPSCadence mode was performed for each lesion using abdominal probe (lowfrequency probe) 5 min before small parts probe (highfrequency probe). ACQ software was used to determine the peak intensity (PI) and the results were analyzed by Student’s t test in pairs. Results: The PI values of all the 6 types of lesions were significantly lower in highfrequency contrastenhanced ultrasound images than those in the lowfrequency contrastenhanced ultrasound images (P<0.001). Conclusion: The microvascular enhancement of superficial lesions by highfrequency CEUS might be lower than the real enhancement intensity. Abdominal lowfrequency probe should be recommended for revealing the perfusion status of superficial lesions after highfrequency probe, which is used for observing the morphology and internal structures of superficial lesions.

Key words: neoplasms superficial lesions high frequency contrast-enhanced ultrasound low frequency contrast enhanced ultrasound SonoVue