【作者】 王丽；

【导师】 王海燕；

【作者基本信息】 吉林大学 ， 影像医学与核医学， 2006， 硕士

【摘要】 目的探讨实时复合成像(SonoCT)、极端分辨率(Xres)新技术对肝癌与肝血管瘤诊断的临床应用价值。方法将80例肝癌(HCC)与肝血管瘤(HHE)分成两组,经SonoCT、Xres图像了解其内部、周边、后方图像特征,并与普通超声图像进行对比。结果一、肝癌与肝血管瘤SonoCT、Xres图像与普通超声图像对比:(一)肝血管瘤SonoCT、Xres图像与普通超声图像对比:1、普通超声显示23.8%HHE边界清楚,21.4%HHE内部细微结构显示清晰。SonoCT、Xres图像显示85.7%HHE边界清楚,90.5%HHE内部细微结构显示清晰,两组图像对肝血管瘤边界及内部细微结构的显示,差异有显著性,P<0.05。2、SonoCT、Xres图像对肝血管瘤内部及周边特征的显示均较普通超声清晰,提供了更多的诊断信息。(二)肝癌SonoCT、Xres图像与普通超声图像对比:1、普通超声显示12.2%的肝癌边界清楚,10.2%内部细微结构显示清晰。SonoCT、Xres图像显示93.9%肝癌边界清楚,95.9%内部细微结构显示清晰,两组图像对肝癌边界及内部细微结构的显示,差异有显著性,P<0.05。2、肝癌周边特征通过SonoCT、Xres图像与普通超声两组图像比较,差异有显著性,P<0.05。SonoCT、Xres图像较普通超声提供了更丰富的内部特征信息。更多还原

【Abstract】 Hepatic carcinoma (HCC) and hepatic hemangioma (HHE) arethe common hepatic space-occupying lesions. But their nature isdifferent. HCC has high rate in degistive systematic malignant tumorin our country, it also has high case fatalty rate and the prognosis of itis bad .So giving diagnosis earlier and therapy earlier is the key ofimproving prognosis and raising survival rate. But as we all know thatHCC is benigh tumor of liver and the growth of it is slow, it does harmto health little. Therefore, the identification of HCC and HHE is veryimport. It has vital clinical significance for treatment and prognosis. The recent coming years, with the development of ultrasonicmedical technology, especially, the applications of new outcomes ofcomputer technology, it improves the accuracy of diagnosis obviously.And it offers valuable diagnosis evidence. SonoCT and Xres are twoquantum jumps in two dimensional imaging. Compared with commonultrasound, SonoCT can gain 9 more times picture information thancommon ultrasonic scanning. So it improves the quality of ultrasonicpicture. Such as speckle, multiple reflection, noise, flare, attenuation,refraction shadowing and so on, those artificial imaging are cancelled.Xres technology improves picture quality by carrying out real-timeanalysis of pixel geometry in a mess disposed. It displays tissuetexture of human body extreme excellent and raises detecting rategreatly. This research is about application of SonoCT and Xrestechnologies in identifications between hepatic carcinomas andhepatic hemangimoas. It makes border and internal structure displaymore clearly, and it strengthens minute resolution in tumor, it gainsvarious tissue information that can’t obtain in common ultrasound. Soit can provide more reliable evidence for diagnosis and raisediagnostic accuracy.Imaging characteristics of hepatic carcinoma and hepatichemangioma in SonoCT and Xres:1 hemangioma imagingcharacteristics: the border strong echo band is typical. Especially, thespecificity of hypo echo small hemangioma is high. The diagnosticvalue is similar to acoustic halo in hepatic carcinoma. Circumferentiafissure signe is the characteristic appearance to HHE. The twocharacter play an important role in diagnosis of hemangimoa.Posterior enhancement effect much more displayed in irradiation. Inaddition, blood sinus echo displayed clearly, the number is much more.While,we can see fiber interval, small vessels, and strip shape hypoecho so on images. 2. imaging characteristics of hepatic carcinoma:the acoustic halo was the typical performence in hepatic carcinoma. Inmy research, the halo can appear sentus, serration or wave changes.And we can see, the outside of halo had strong echo zone surroundingdiscontinuous or continual. Posterior enhancement effect much moredisplayed in endoduction. There were some signs in hepatic carcinoma,such as strip shape, small fiber zone, blood vessel desected and so on.The contrast of SonoCT、Xres images between hepatic carcinoma andhepatic hemangioma: 1.the ring of strong echo at the hemangioma’sborder;2.the halo:the characteristic appearance of hepatic carcinoma.3.Strip shape hypo echo was confirmed vessel structure intratumoral.Hepatic carcinomas mostly show off courser twisted and irregularstrip shape hypo echo. Because of local small vascular engorgement,stasis, expansion, hepatic hemangiomas almost show normal vesselecho of courser straight. 4. Hepatic carcinoma and hemangioma allcan be seen posterior enhancement effect. Hepatic carcinoma almostshowed off adduction, but hemangioma mostly showed off irradiationor verticality.Compared with the image of common ultrasound, the result ofSonoCT、Xres in hepatic carcinoma and hepatic hemangioma asfollowing: 1. The comparison between common ultrasound andSonoCT、Xres images in hepatic hemangioma: ①the images ofSonoCT、Xres displayed more clearly than common ultrasoundimages, and SonoCT、Xres showed off the numbers of Circumferentiafissure signe more than common ultrasound. The difference issignificant in two sets. P 0.05.②the images of SonoCT、Xresdisplayed more information than common ultrasound in hemangioma.2. The comparison between common ultrasound and SonoCT、Xresimages in hepatic carcinoma:①the images of SonoCT、Xres was moreclearly than common ultrasound towardsing the halo and the strongecho zone outside. The difference is significant in two sets. P 0.05.②the images of SonoCT、Xres displayed more information thancommon ultrasound in hepatic carcinoma.Three-dimensional color power angiography (3D-CPA) imagingcharacteristics: According to the numbers vessels in tumor, theaffection was divided into hypo-vessel and hyper-vessel. Hepaticcarcinomas always showed off hyper-vessel. It’s appearance of3D-CPA was complicated and various. It displayed such as branchshape, reticulate, radiate and so on. Hemangiomas always showed offhypo-vessel.SonoCT combined with Xres are superior to the commonultrasound in the two dimensional ultrasonic diagnosis betweenhepatic carcinoma and hemangioma. They can not only gain morevarious tissue information than common ultrasound, but also cancancel artifacts such as speckle noise, echo attenuation and so on.They provide reliable evidence and raised accuracy of diagnosis. Theyare safe, convenient, reproducibale and so on, at the same time theyavoid unnecessary wound and medical cost.更多还原