Focal hepatic lesions: contrast-enhancement patterns at pulse-inversion harmonic US using a microbubble contrast agent.
Focal hepatic lesions: contrast-enhancement patterns at pulse-inversion harmonic US using a microbubble contrast agent.
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DOI：
10.3348/kjr.2003.4.4.224
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发表时间：
2003-10
影响因子：
4.8
通讯作者：
Won JJ
中科院分区：
文献类型：
--
作者：
Kim EA;Yoon KH;Lee YH;Kim HW;Juhng SK;Won JJ
分析局灶性肝脏病变的脉冲反转谐波成像 (PIHI) 获得的对比增强模式，从而确定肿瘤血管分布和声发射效应。我们回顾了 90 名连续患有局灶性肝脏病变的患者的脉冲反转图像，即肝细胞癌 (HCC) (n=43)、转移瘤 (n=30) 和血管瘤 (n=17)。注射微泡造影剂后立即和五分钟获得血管和延迟期图像。血管期成像时的肿瘤血管分布和延迟期成像时的声发射效应各自被分类为四种模式之一。血管期图像显示 93% 的 HCC 中存在内部血管，83% 的转移瘤中显示边缘血管，71% 的血管瘤中显示外周结节状强化。延迟相位图像显示 86% 的 HCC 不均匀强化；低回声，93% 的转移灶增强减弱； 65% 的血管瘤呈低回声和反向回声。血管和延迟期增强模式分别与 91% 或更高和 92% 或更高的特异性相关，并且分别与 71% 或更高和 85% 或更高的阳性预测值相关。描述肿瘤血管分布的对比增强模式和 PIHI 的声发射效应可以帮助区分局灶性肝脏病变。
To analyze the contrast-enhancement patterns obtained at pulse-inversion harmonic imaging (PIHI) of focal hepatic lesions, and to thus determine tumor vascularity and the acoustic emission effect. We reviewed pulse-inversion images in 90 consecutive patients with focal hepatic lesions, namely hepatocellular carcinoma (HCC) (n=43), metastases (n=30), and hemangioma (n=17). Vascular and delayed phase images were obtained immediately and five minutes following the injection of a microbubble contrast agent. Tumoral vascularity at vascular phase imaging and the acoustic emission effect at delayed phase imaging were each classified as one of four patterns. Vascular phase images depicted internal vessels in 93% of HCCs, marginal vessels in 83% of metastases, and peripheral nodular enhancement in 71% of hemangiomas. Delayed phase images showed inhomogeneous enhancement in 86% of HCCs; hypoechoic, decreased enhancement in 93% of metastases; and hypoechoic and reversed echogenicity in 65% of hemangiomas. Vascular and delayed phase enhancement patterns were associated with a specificity of 91% or greater, and 92% or greater, respectively, and with positive predictive values of 71% or greater, and 85% or greater, respectively. Contrast-enhancement patterns depicting tumoral vascularity and the acoustic emission effect at PIHI can help differentiate focal hepatic lesions.