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CEUS of focal liver lesions time - relative intensity curve analysis and angiography in patients with Tongue features Preliminary

Author: SunZuoPeng
Tutor: ZhaoYuZhen
School: Beijing University of Traditional Chinese Medicine
Course: Traditional Chinese Medicine
Keywords: CEUS Enhanced mode Time - intensity curve Acoustic quantitative parameters Time - relative intensity curve Tongue features
CLC: R445.1
Type: Master's thesis
Year: 2010
Downloads: 31
Quote: 0
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Abstract


Purpose: the application of reverse pulse harmonic imaging technology and SonoVue contrast agent, 59 focal liver lesions (focal liver lesions, FLL) CEUS (contrast enhanced ultrasound, CEUS) check using the QLAB quantitative software and EXCEL software time - intensity curve (time-intensity curve, TIC) and time - relative intensity curve (time-relative-intensity curve, TRIO) were drawn. Observed the FLL ultrasound contrast-enhanced mode, contrast benign and malignant liver lesions ultrasound contrast TIC morphology and quantitative parameters characteristic, explore the diagnostic value of the the TRIC morphological features of benign and malignant lesions. Analysis of angiography in patients with Tongue differences. Methods: Philips iU22 ultrasound diagnostic equipment, application of reverse pulse harmonic imaging techniques, contrast agent SonoVue phospholipid microbubbles Bracco company. Applied first routine ultrasound scanning of the liver of the patients to observe and record the lesion number, location, size, echo characteristics and distribution of blood flow. Switch to choose the best lesion section angiography the mechanical index tune of 0.06 side / side double amplitude contrast mode, the left side of the monitor screen to receive only the harmonic signal contrast mode, the right to observe the anatomical structure of the fundamental status. Then after elbow shallow good contrast agent bolus preparation 2.4ml, followed by an immediate injection of 5ml normal saline, at the same time to start instrument built-in timer and the entire contrast the process of recording instrument, real-time the observed lesion ultrasound contrast-enhanced subsided mode. The dynamic image export angiographic will offline analysis, using QLAB quantification software lesion and surrounding liver parenchyma were drawn TIC, and obtain the acoustic quantitative parameters. Time intensity curve on each frame corresponds to the time and sound intensity can be exported to Excel software, minus the liver parenchyma lesions sound intensity corresponding sound intensity each time difference relative strength. Time as the abscissa, the relative strength of the vertical coordinate to draw TRIC type according to the characteristics of the the TRIC decline in support. Tongue features observed in patients with benign and malignant. Results: 1. Homogeneous enhancement and inhomogeneous enhancement prevalent in primary hepatocellular carcinoma (primary liver carcinoma, PLC) and metastatic liver cancer (metastasis liver carcinoma, MLC), concentric enhancement seen in hepatic hemangiomas (hepatic hemangioma, HH), centrifugal enhancements found in focal nodular hyperplasia (focal nodular hyperplasia FNH), and other enhancements found in the fatty liver focal fatty missing (focal fatty sparing, FFS) and cirrhosis of the liver regenerative nodules (the hepatic cirrhosis regenerative nodule HCRN). 2 malignant lesions the TIC was \Malignant lesions peak time, and enhanced time were less than benign lesions, the difference was statistically significant (P lt; 0.001), the slope of the ascending branch of the malignant lesions than benign lesions, the difference was statistically significant (P lt; 0.01) malignant lesions greater than the slope of the descending branch benign lesions, and the difference was statistically significant (P lt; 0.001). 4 of malignant lesions TRIC type Ⅲ main benign lesions the TRIC performance for the type Ⅰ, Ⅱ. Malignant lesions TRIC steep ascending branch and descending branch than those in average (28.24 ± 8.14) s when Scientology line 0 value, and continue to fall to below the baseline after a slight rebound in the near -8 dB. The benign lesions TRIC rose branch and descending branch than gentle decline in support fell to 4 dB on the baseline near the small fluctuations. The proportion of patients with malignant thick yellow greasy moss significantly more than patients with benign tumors, the difference was statistically significant (P <0.05). Patients with malignant Tongue fat and large the tongue proportion of more than benign lesions, the difference was statistically significant (P lt; 0.05). Conclusion: CEUS improved acoustic differences between the liver parenchyma and lesions, lesions enhanced imaging mode provides the the FLL blood supply specific information the qualitative diagnosis rate of liver tumor perfusion lesions over time in different ways. The ultrasound contrast TIC morphological, the acoustics quantitative parameters change with different characteristics, with a high clinical value in differentiating benign and malignant lesions of the liver. 3. TRIC visually reflects the different FLL surrounding normal liver parenchyma sound intensity discrepancy TRIC greater than the value of 0 that the sound of the moment lesions powerful in the surrounding normal liver parenchyma, and less than the portion of the value of 0 indicates that the moment lesion sound intensity is less than the surrounding liver parenchyma, FLL's TRIC different morphology different. TRIC declined to support the decline in the degree of the different energy than TIC more intuitive to reflect the image of benign and malignant lesions, the diagnosis of specific lesions can be combined with comprehensive analysis of lesion enhanced mode. Liver malignancies in patients with thick yellow greasy moss and tongue-shaped anomaly is higher than in patients with benign liver tumors, tongue diagnosis has some clinical value in the diagnosis of differentiating benign and malignant tumors.

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