经直肠超声造影鉴别诊断直肠癌与直肠间质瘤

发布时间：2018-11-07 12:41

【摘要】：目的探讨经直肠CEUS鉴别诊断直肠癌与直肠间质瘤的价值。方法选取接受手术切除的直肠肿瘤患者44例,根据术前经直肠CEUS检查结果分为直肠癌组29例和直肠间质瘤组15例,另设同种肿瘤周围正常肠壁分别为对照1组和对照2组。观察造影剂在直肠肿瘤患者的充盈灌注情况,并与各自相应对照组比较。以对照组为参照,采用SonoLiver分析软件绘制肿瘤与正常肠壁的时间强-度曲线(TIC),并对曲线形态和峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)及平均渡越时间(mTT)进行比较。结果与各自相应对照组比较,直肠癌组总体造影表现为"快进快出"的高增强模式,直肠间质瘤组表现为"慢进慢出"的低增强模式。直肠癌组IMAX值高于对照1组[(122.42±15.99)%vs100%],而RT[(6.02±1.54)s vs(8.01±1.63)s]、TTP[(8.30±1.59)s vs(10.73±3.03)s]、mTT[(14.40±2.51)s vs(18.77±4.14)s]均小于对照1组(P均0.05);直肠间质瘤组IMAX低于对照2组[(55.40±8.33)%vs 100%],而RT[(9.73±1.61)s vs(7.50±1.82)s]、TTP[(18.03±1.91)s vs(9.51±1.24)s]、mTT[(20.17±23.10)s vs(17.92±1.81)s]均大于对照2组(P均0.05)。结论直肠癌与直肠间质瘤的CEUS表现存在明显差异,结合TIC和造影参数,有助于鉴别直肠癌和直肠间质瘤。
[Abstract]:Objective to evaluate the value of transrectal CEUS in differential diagnosis of rectal cancer and rectal stromal tumor. Methods Forty-four patients with rectal tumor underwent surgical resection were divided into rectal cancer group (n = 29) and rectal stromal tumor group (n = 15) according to the results of preoperative transrectal CEUS examination. The normal intestinal wall around the same tumor was divided into control group 1 and control group 2 respectively. The filling and perfusion of contrast media in rectal tumor patients were observed and compared with the corresponding control groups. SonoLiver analysis software was used to draw the time-intensity curve (TIC), of tumor and normal intestinal wall, and the curve shape and peak intensity (IMAX), rising time (RT), were compared with the control group. The peak time (TTP) was compared with the average transit time (mTT). Results compared with the corresponding control group, the overall enhancement pattern of rectal cancer group was "fast in and out" mode, and that of rectal stromal tumor group was "slow in and slow out" mode. The IMAX value of rectal cancer group was higher than that of control group [(122.42 卤15.99)% vs100%], but RT [(6.02 卤1.54) s vs () 8.01 卤1.63) s, TTP [(8.30 卤1.59) s vs () 10.73 卤3.03) s]. MTT [(14.40 卤2.51) s vs (18.77 卤4.14) s] was lower than that of the control group (all P 0.05). The IMAX of rectal stromal tumor group was lower than that of control group [(55.40 卤8.33)% vs 100%], but RT [(9.73 卤1.61) s vs (7.50 卤1.82) s], TTP [(18.03 卤1.91) s vs (9.51 卤1.24 s]. MTT [(20.17 卤23.10) s vs () 17.92 卤1.81 s] was higher than that of the control group (P 0.05). Conclusion there is significant difference in CEUS between rectal cancer and rectal stromal tumor. Combined with TIC and imaging parameters, it is helpful to distinguish rectal cancer from rectal stromal tumor.
【作者单位】：中国医科大学附属盛京医院超声科;
【分类号】：R735.37;R445.1

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