摘要
目的探讨肠壁炎症增厚性和肿瘤性病变灰阶超声造影特征及其在鉴别诊断中的临床意义。方法应用静脉团注SonoVue对36例(13例炎性病变、23例肿瘤性病变)肠壁增厚性病变患者进行低机械指数超声造影检查,实时观察增厚肠壁的动态血流灌注特征,利用定量分析软件进行时间-强度曲线(TIC)分析,观察并测定微血管密度(MVD)情况,比较TIC曲线参数与MVD之间关系。结果肠壁炎性增厚病变,灰阶超声造影显示肠壁黏膜、黏膜下层或全层均匀一致增强;肿瘤性病变,造影显示所有病例肿瘤病变区均有不同程度增强,增强层次不清、顺序紊乱;肿瘤性病变MVD值大于炎症性病变,两者比较差异有统计学意义(P<0.01);TIC曲线表现:黏膜下层病变,达峰时间均较肌层提前,斜率较肌层增大;病变侵犯全层,曲线显示相当于黏膜下层与肌层的部位强化一致,TIC曲线参数分析表明,肠壁炎性增厚性病变与肿瘤性病变,峰值背向散射强度(PI)及强度减半时间(T1/2)均与血流状态有关,而与MVD无关。结论灰阶超声造影结合TIC曲线,可以说明肠壁炎症性与肿瘤性病变具有不同的血流动力学特征,且可以更加清晰显示病变的微血管分布情况及其浸润范围,有助于肠壁炎症性与肿瘤性病变的鉴别诊断。
Objective To evaluate features of gray scale contrast-enhanced ultrasound in the inflammatory and neoplastic disease of intestinal wall and it＇s clinical significance in the differential diagnosis. Methods Thirty-six intestinal wall thickened patients（ 13 inflammatory lesions and 23 neoplastic lesions） with all lesions confirmed were studied after intravenous bo- lus injection of SonoVue. We recorded sonographic perfusion images and calculated perfusion time-intensity curve（TIC） by quantitative analytic software and counted microvessel density （MVD）of all lesions. Correlation analysis was studied between TIC parameters and MVD of all lesions, Results The intestinal wall inflammatory lesions demonstrated homogenous enhancement of the mucous layer, the submucous layer or all layers uniformly. On the contrary, neopalstic lesions of the intestinal wall showed inequality enhancement in a disorder form without sequence. There were more MVDs in neoplastic group than inflammatory group（P〈0.01）. For submucous lesions（both inflammatory and neoplastic lesion）, TIC parameters showed time of peak signal enhancement earlier than muscular layer and with a higher slope rate. For lesions infiltrating all layers, there were same enhancement form of both submucous layer and muscular layer. The TIC parameters showed peak back scattering intensity（PI） and time of half bubble wash out（T1 2 ） of two groups were influenced by blood flow and had no correlation with MVD. Conclusion Gray scale contrast-enhanced ultrasound with TIC parameters analysis demonstrates the different hemodynamic changes of intestinal inflammatory lesions and neoplastic lesions, it also reflects micro-vascularity distribution and lesion infiltration more clearly, which conduce to differential diagnosis between inflammatory and neoplastic lesions of intestinal wall.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第5期696-699,共4页
Chinese Journal of Medical Imaging Technology
关键词
超声造影
肠壁
血流灌注
时间-强度曲线
微血管密度
Contrast-enhanced ultrasound
Intestinal wall
Blood perfusion
Time-intensity curve
Microvessel density
