| 黄丽萍,王嘉俊,李红丹,刘守君,任卫东.实时超声造影鉴别诊断肝脏瘤样病变[J].中国医学影像技术,2012,28(2):311~314 |
| 实时超声造影鉴别诊断肝脏瘤样病变 |
| Differential diagnosis of hepatic tumor-like lesions with real time contrast enhanced ultrasonography |
| 投稿时间：2011-05-04 修订日期：2011-07-24 |
| DOI： |
| 中文关键词: 肝脏疾病 超声检查 造影剂 |
| 英文关键词:Liver diseases Ultrasonography Contrast media |
| 基金项目:辽宁省教育厅基金(2008T210)。 |
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| 中文摘要: |
| 目的 应用CEUS评价肝脏瘤样病变的血流灌注特征。 方法 选择35例瘤样病变患者(41个病灶)作为研究对象,21例经手术证实,14例经增强CT/MRI或随访证实。 结果 肝局灶性结节增生(FNH)13例,动脉相100%(13/13)高增强,动脉相早期10例呈中心向周边轮辐样强化,3例为从中心向周边强化范围逐渐扩大,周边出现一过性未强化带;门脉相100%(13/13)呈均匀高增强,延迟相84.62%(11/13)等或高增强,15.38(2/13)中心部低增强。肝孤立性坏死结节(SNN)12例,三相均未见强化,病灶大小、数目不一,形态各异。肝炎性假瘤(IPL)4例,动脉相高增强,门脉相低增强。肝局灶性脂肪变(FFC)6例,动脉相33.33%(2/6)高增强,16.67%(1/6)低增强,50.00%(3/6)等增强,门脉相及延迟相呈等增强。 结论 肝FNH、SNN和FFC的CEUS具有特异性表现,而IPL需与原发性肝细胞癌相鉴别。 |
| 英文摘要: |
| Objective To observe the blood flow characteristics of hepatic tumor-like lesions with CEUS. Methods Totally 41 lesions in 35 patients of tumor-like lesions were evaluated. Among them, 21 cases were confirmed with surgery, 14 with enhanced CT/MRI or follow-up. Results Hyperenhancement in the arterial phase was observed in all 13 FNHs (13/13, 100%). Central spoke wheel-shaped enhancement during early arterial phase was found in 10 cases of FNH, while central enhancement and a transient peripheral unenhanced zone was seen in 3 FNHs. Hyperenhancement in the portal venous phase was seen in all FNHs (13/13, 100%), while hyper or isoenhancement (11/13, 84.62%) and central hypoenhancement (2/13, 15.38%) were detected in the late phase. Twelve patients with solitary necrotic nodules (SNN) showed no enhancement throughout three phases, but the size and shape were all different. Four patients with inflammatory pseudotumor of the liver (IPL) showed diffuse hyperenhancement in the arterial phase and washout rapidly in portal venous phase. In 6 patients with focal fatty change (FFC), hyperenhancement (2/6, 33.33%), hypoenhancement (1/6, 16.67%) and isoenhancement (3/6, 50.00%) were found in arterial phase, whereas isoenhancement in the portal venous and late phase were noticed in all 6 patients. Conclusion FNH, SNN and FFC have specific performance during CEUS. IPL should be differentiated from primary hepatocellular carcinoma. |
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