张小龙　王文平　黄备建　丁红　董怡　陆清　毛枫

( 复旦大学附属中山医院超声科，上海　200032)



·论著·

结直肠癌肝转移灶超声造影与CT影像表现的比较

张小龙王文平黄备建丁红董怡陆清毛枫

( 复旦大学附属中山医院超声科，上海200032)

摘要目的： 比较结直肠癌肝转移灶超声造影与增强CT血流灌注的异同。方法： 对比60例60个结直肠癌肝转移灶超声造影与增强CT动脉期及门脉期的增强表现。结果： 60个病灶超声造影动脉期均增强，53.3%(32/60)周边增强，46.7%(28/60)整体增强；增强CT见 78.3 %(47/60)的病灶周边增强，16.7%(10/60)整体增强，5%(3/60)未见增强(P<0.01)。动脉期病灶的增强程度方面，超声造影示93.3%(56/60)的病灶增强程度高于肝实质，6.7%(4/60)增强程度低于肝实质；增强CT示 91.2%(52/57)的病灶增强程度高于肝实质，8.8%(5/57)增强程度低于肝实质(P>0.05)；门脉期，超声造影示100%(60/60)的病灶增强减退，较周围肝实质呈低回声，增强CT门脉期示 100%(60/60)的病灶较周围肝实质呈低密度，两种影像方法所示的转移灶增强程度均低于肝实质(P>0.05)。结论： 结直肠癌肝转移灶的超声造影和增强CT增强表现不完全相同，超声造影在反映部分结直肠癌肝转移灶动脉血流灌注方面较增强CT有一定优势。

关键词转移性肝癌；结直肠癌；超声检查；造影剂；X-线断层摄影

Enhancement of Colorectal Carcinoma Liver Metastasis: Comparison of Contrast-Enhanced Ultrasound and Contrast-Enhanced Computed Tomography

ZHANGXiaolongWANGWenpingHUANGBeijianDINGHongDONGYiLUQingMAOFeng

DepartmentofUltrasound,ZhongshanHospital,FudanUniversity,Shanghai200032,China

AbstractObjective： To compare blood perfusion visibility of contrast-enhanced ultrasound (CEUS) in colorectal carcinoma (CRC) liver metastasis with contrast-enhanced computed tomography (CECT).Methods： Sixty cases of CRC liver metastasis in Zhongshan Hospital, Fudan University were enrolled in this study and were analyzed with both CEUS and CECT.Results： At arterial phase, 53.3%(32/60) lesions showed rim-like enhancement and 46.7% (28/60) lesions showed total enhancement on CEUS，while on CECT, rim-like enhancement, total enhancement and no enhancement were detected in 78.3% (47/60) lesions, 16.7% (10/60) lesions and 5% (3/60) lesions lesions, respectively (P<0.01). At peak enhancement, 93.3% (56/60) lesions showed higher enhancement and 6.7% (4/60) lesions showed lower enhancement on CEUS，which were detected in 91.2%(52/57) lesions and 8.8%(5/57) lesions at arterial phase of CECT, respectively (P>0.05). At portal venous phase, all lesions showed lower enhancement on both CEUS and CECT (P>0.05).Conclusions： The blood perfusion appearance of CRC liver metastasis with CEUS is not identical as that of CECT. Among some cases, CEUS is superior to CECT on arterial perfusion visualization of liver metastasis.

Key WordsLiver metastasis; Colorectal carcinoma; Ultrasonography; Contrast media; X-ray computed; Tomography

影像学方法除了在肿瘤诊断、分期方面发挥着重要作用外，在肿瘤治疗疗效评价方面的作用也日益突出。目前，临床广泛采用的疗效评价标准RECIST或mRECIST主要侧重于观察病灶的大小及数目，而对病灶血流灌注变化的评估还有待深入，本研究拟通过对结直肠癌肝转移灶超声造影和CT增强表现的比较，探讨超声造影反映结直肠癌肝转移灶血流灌注的价值。

1资料与方法

1.1一般资料2015年3月—2015年8月至我院就诊的结直肠癌肝转移患者60例，其中，男性41例，女性19例，年龄29~78岁，平均(59.2±9.8)岁。同时……