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Objective To investigate the characteristics of the contrast agent SonoVue in gray-scale
ultrasound in various liver neoplasms and to evaluate its value in the diagnosis of hepatic tumor.
Methods Real-time contrast-enhanced ultrasound was performed in 72 patients with space-occupying lesions of the liver, including 30 cases ofprimary hepatic carcinoma, 17 of metastatic hepatic carcinoma, 8 of hepatic hemangioma, 7 of focal nodular hyperplasia(FHN)，9 of liver nodular cirrhosis and 1 of inflammatory mass. In all of them, the results were compared with those of color Doppler ultrasound, enhanced CT and pathologic examinations.
Results After injection of Sonovue, all the lesions were variously enhanced on real-time ultrasonography. Specifically, a holistic inhomogeneous enhanced pattern with quick appearing of arterial phase and quick disappearing of portal phase was mostly detected in hepatic carcinoma; a slowperipheral and centripetal enhanced pattern of the portal vein with relatively long display of contrast agent wasmostly shown in hemangioma; the enhancement pattern of metastatic hepatic carcinoma was diverse, including even or peripheral enhancement in the arterial phase with internal spotty enhancement, the echo was weakened rapidly in portal use and the focus were discovered easily; and a radial centrifugal enhanced pattern with homogeneity of the portal use was quickly observed in FNHS with an obvious intake of the contrust agent during the delay phase.
Conclusions The dynamic enhanced fashions and various enhanced fealures in different hepatic tumors can he reflected by real-time contrast-enhanced ultrasound, which improves the accuracy, sensitivity and specificity of ultrasonography in the diagnosis of liver tumors.
Key words Ultrasonography;Contrast media;Liver diseases
肝内占位病变的良恶性鉴别至关重要，而两者的常规超声表现常有重叠，难以鉴别。以往灰阶超声造影多选用利生显(Levovist)作为超声造影剂进行间歇造影成像，图像缺乏连续性，不能完整观察整个病灶的增强情况。随着实时灰阶超声造影成像技术的出现，使超声能按时相评价肝内占位性病变的血流灌注特点，实时灰阶超声造影成像方法是用低机械指数(MI<0.4)及谐波成像技术，达到实时动态超声造影增强成像。在注入造影剂后，可按不同的造影剂灌注时相，获取造影剂的增强图像，以便准确评价病变的血供模式及病变的性质。肝造影增强一般分为肝动脉期(注射造影剂后15一25s)，门脉早期(40一55s)，门静脉晚期(70一85s)以及肝实质期或延迟期(180一200s或更长)[1]:。本研究采用新型造影剂声诺维(SonoVue)对72例肝脏占位性病变患者进行实时超声造影，了解造影剂在各种肝占位性病变中的造影灌注时相、回声变化规律、造影后肿瘤的检出状况及在临床中的应用。
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