摘要
目的探讨超声造影在附件良、恶性包块诊断中的临床应用价值。方法对31例附件包块(良性组20例,恶性组11例)进行经阴道灰阶实时超声造影,并进行微血管成像(MVI)及时间-强度曲线分析。结果①MVI显示良性病变组微血管不丰富,血管形态规则;恶性肿瘤则见极丰富的微血管,且血管形态异常,可见粗大不规则的肿瘤血管。②恶性组造影增强强度及廓清时间显著大于良性组(P<0.05)。结论经阴道灰阶超声造影有助于提高对附件包块良、恶性病变的鉴别诊断能力及诊断信心。
Objective To investigate the potential efficacy of transvaginal contrast enhanced sonography in benign and malignant adnexal masses in a pilot study with a special focus on the microvascular imaging （MVI）,a new microbubble mode which integrates the microbubble signal over time to provide a map of tumor vessels throughout a lesion. Methods Thirty one patients with adnexal masses were performed preoperatively with transvaginal contrast-enhanced sonography using the pulse-inversion harmonic imaging. Following the bonus intravenous injection of 2.4 ml SonoVue, the behavior of the realtime images with contrast enhanced sonography were observed and the live loop obtained during a 4-minute examination were stored digitally. The MVI were processed with a computer program. The track of the microbubbles captured with the MVI were evaluated both in benign and malignant lesions. Also the enhanced parameters of both the benign masses and malignancies were analyzed with time-intensity curves. Results There were 20 cases of benign adnexal masses and 11 cases of ovarian malignancies among 31 patients. The vascular morphological findings on MVI showed that the benign adnexal masses had simple vascular pattern, normal vessel calibers and low microvessel density, while malignant tumors showed heterogeneous features. The morphological abnormalities of malignancies on MVI included the tortuous, irregular caliber vascular patter and much higher microvessel density. The maximum contrast enhanced intensities [（48.5±29.3）dB vs （81.9± 27.8）dB, P 〈0.05], as well as wash-out time [（98.4± 29.0）s vs （138.7 ± 55.8）s, P〈0. 05] were significantly higher in malignant lesions as compared with benign masses. Conclusions The MVI emphasize better visualizations of adnexal lesion vascularity and microvessels. The transvaginal contrast-enhanced sonography is helpful for improving the confidence in diagnosis of benign and malignant adnexal masses.
出处
《中华超声影像学杂志》
CSCD
2006年第9期693-697,共5页
Chinese Journal of Ultrasonography
