CAJ | 학술논문

目的探讨超声造影参数图像处理在卵巢肿块诊断中的应用价值。方法 2008年1月至2010年12月在武汉大学人民医院行常规超声检查发现的50例卵巢肿块病例，其中良性肿块28例，恶性肿块22例，对其进行常规超声和超声造影检查，应用超声造影参数图像处理软件实时无创动态分析卵巢肿块组织血管的生成和血流灌注模式，比较其时间-强度曲线(TIC)和动态血管模式曲线(DVP)的形态特征，并对TIC各项定量指标进行分析。结果卵巢肿块的超声造影图像中，良性肿块有24例(86％)显示内部以蓝色为主的低增强，恶性肿块有15例(68％)显示内部以红色为主的高增强，差异有统计学意义(P＜0.01)；良性肿块中，23例( 82％) DVP曲线在造影全过程全部时段保持在基线之下，恶性肿块中有15例(68％) DVP曲线在造影全过程全部时段保持在基线之上；造影剂达峰强度恶性肿块显著高于良性肿块(P =0.000)，达峰时间及平均渡越时间恶性肿块短于良性肿块[ (28±11)s比（65±19）s，(74±29)s比(154±52)s]，差异均有统计学意义（均P＜0.05）。始增时间恶性肿块短于良性肿块[(23±10)s比(44±11)s]，差异有统计学意义(P＞0.05)。结论卵巢肿块的超声造影TIC、DVP曲线在良恶性之间存在明显差异，而结合了超声造影参数图像处理软件可更加直观地反映良恶性肿块的定量信息。
목적 탐토초성조영삼수도상처리재란소종괴진단중적응용개치。방법 2008년1월지2010년12월재무한대학인민의원행상규초성검사발현적50례란소종괴병례，기중량성종괴28례，악성종괴22례，대기진행상규초성화초성조영검사，응용초성조영삼수도상처리연건실시무창동태분석란소종괴조직혈관적생성화혈류관주모식，비교기시간-강도곡선(TIC)화동태혈관모식곡선(DVP)적형태특정，병대TIC각항정량지표진행분석。결과 란소종괴적초성조영도상중，량성종괴유24례(86％)현시내부이람색위주적저증강，악성종괴유15례(68％)현시내부이홍색위주적고증강，차이유통계학의의(P＜0.01)；량성종괴중，23례( 82％) DVP곡선재조영전과정전부시단보지재기선지하，악성종괴중유15례(68％) DVP곡선재조영전과정전부시단보지재기선지상；조영제체봉강도악성종괴현저고우량성종괴(P =0.000)，체봉시간급평균도월시간악성종괴단우량성종괴[ (28±11)s비（65±19）s，(74±29)s비(154±52)s]，차이균유통계학의의（균P＜0.05）。시증시간악성종괴단우량성종괴[(23±10)s비(44±11)s]，차이유통계학의의(P＞0.05)。결론 란소종괴적초성조영TIC、DVP곡선재량악성지간존재명현차이，이결합료초성조영삼수도상처리연건가경가직관지반영량악성종괴적정량신식。
Objective To investigate application value of parametric image processing in contrastenhanced ultrasound imaging in diagnosis of ovarian masses. MethodsFifty cases with ovarian masses underwent routine ultrasound and contrast-enhanced ultrasound imaging using a new dedicated parametric image processing software SonoLiver to analyze patterns of vascular formation and blood stream perfusion in the ovarian mass tissues on a digital video recorder in real time, compare their morphological characteristics of time-intensity curve (TIC) and dynamic vascular patterns (DVP) curve, and analyze quantitatively all indicators generated by SonoLiver. ResultsIn ultrasound imaging of the 50 cases, there were 24 cases (86％) displaying mainly blue lowly-enhanced imaging in those with benign masses and 15 cases (68％)displaying mainly red highly-enhanced imaging in those with malignant masses, with statistical significance (P ＜0. 01 ). There was significantly different characteristics of TIC and DVP between patients with benign and malignant masses. In 23 cases with benign masses, their DVP were significantly higher above the baseline than in those with malignant ones ( P = 0. 000), and in 15 cases with malignant lesions, their DVP were much shorter below the baseline than in those with benign ones, with statistical significance (P ＜0.05). The intensity of contrast medium, the time to reach its peak intensity and average transit time were all significantly higher in those with malignant masses than in those with benign ones (all P ＜ 0. 05 ). But, no statistical difference in the time of initial increasing between the two groups was found (P ＞ 0. 05). Conclusions There is significant difference in TIC and DVP of ultrasound imaging between benign and malignant masses, which if combined with contrast enhanced ultrasound parametric image processing can provide a more visualized quantitative information of benign and malignant ovarian masses with SonoLiver software.