Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography
Dynamic imaging of pancreatic diseases by contrast enhanced coded phase inversion harmonic ultrasonography
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DOI：
10.1136/gut.2003.029934
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发表时间：
2004-06-01
期刊：
影响因子：
24.5
通讯作者：
Kawasaki, T
中科院分区：
文献类型：
--
作者：
Kitano, M;Kudo, M;Kawasaki, T
背景资料：编码反相谐波超声是一种新的超声技术，它使用含有单糖的超声造影剂，能够以真实的时间方式显示微小血管中的慢血流。我们的目的是采用这种新的技术来观察胰腺tumors.Subjects和方法中的微血管：65例可疑胰腺肿瘤的对比增强编码相位反转谐波超声，对比增强计算机断层扫描，超声内镜。根据组织学检查结果，最终诊断为胰腺导管癌49例，慢性胰腺炎性假瘤7例，内分泌肿瘤9例。对于对比增强编码谐波超声，静脉注射造影剂Levovist。当胰腺中出现第一个微泡信号时，理想扫描平面的图像以真实的时间连续的方式显示（血管图像）。随后，进行间隔延迟扫描（灌注图像）以显示实质血流。肿瘤血管通过使用两种类型的成像进行评价。描述胰腺肿瘤的灵敏度进行了比较之间的三examination.Results：对比增强超声检查显示肿瘤血管在67%的胰腺导管癌，虽然大多数是相对少血供与周围的胰腺组织相比。通过对比增强超声检查获得的肿瘤血管模式与通过对比增强计算机断层扫描获得的肿瘤血管模式密切相关。在描绘胰腺肿瘤的2厘米或更小的尺寸的敏感性值为68%，对比增强计算机断层扫描，95%的内镜超声，95%的对比增强ultrasonography.Conclusion：对比增强编码相位反转谐波超声检查成功地可视化胰腺肿瘤的细血管，并可能发挥关键作用，在胰腺肿瘤的描述和鉴别诊断。
Background: Coded phase inversion harmonic ultrasonography, a newly available sonographic technique, enables visualisation of slow flow in minute vessels in a real time fashion with the use of a sonographic contrast agent containing monosaccharide. Our purpose was to employ this novel technique to observe microvessels in pancreatic tumours.Subjects and methods: Sixty five patients with suspicious pancreatic tumours received contrast enhanced coded phase inversion harmonic ultrasonography, contrast enhanced computed tomography, and endosonography. Final diagnoses based on histological findings were pancreatic ductal carcinomas in 49 patients, inflammatory pseudotumours with chronic pancreatitis in seven, and endocrine tumours in nine. For contrast enhanced coded harmonic ultrasonography, Levovist, a contrast agent, was injected intravenously as a bolus. When the first microbubble signal appeared in the pancreas, images of the ideal scanning plane were displayed in a real time continuous fashion (vessel images). Subsequently, interval delay scanning (perfusion images) was taken to demonstrate parenchymal flow. Tumour vascularity was evaluated by using the two types of imaging. Sensitivities for depicting pancreatic tumours were compared between three examinations.Results: Contrast enhanced ultrasonography demonstrated tumour vessels in 67% of pancreatic ductal carcinomas, although most were relatively hypovascular compared with the surrounding pancreatic tissue. The vascular patterns of tumours obtained by contrast enhanced ultrasonography were closely correlated with those obtained by contrast enhanced computed tomography. Values for sensitivity in depicting pancreatic tumours of 2 cm or less in size were 68% for contrast enhanced computed tomography, 95% for endosonography, and 95% for contrast enhanced ultrasonography.Conclusion: Contrast enhanced coded phase inversion harmonic ultrasonography successfully visualised fine vessels in pancreatic tumours and may play a pivotal role in the depiction and differential diagnosis of pancreatic tumours.