| 赵丹,逯川英子,罗渝昆,张艳.超声造影诊断脾淋巴瘤[J].中国医学影像技术,2025,41(2):291~294 |
| 超声造影诊断脾淋巴瘤 |
| Contrast-enhanced ultrasound for diagnosing splenic lymphoma |
| 投稿时间：2024-09-15 修订日期：2024-12-05 |
| DOI：10.13929/j.issn.1003-3289.2025.02.023 |
| 中文关键词: 脾脏 淋巴瘤 超声造影 |
| 英文关键词:spleen lymphoma contrast-enhanced ultrasound |
| 基金项目: |
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| 中文摘要: |
| 目的 观察超声造影(CEUS)诊断脾淋巴瘤的价值。方法 回顾性收集经病理确诊的18例脾淋巴瘤,观察病变常规超声及CEUS表现,比较二者诊断脾淋巴瘤的准确率。结果 常规超声显示,18例中,单发病变8例(8/18,44.44%)、多发病变10例(10/18,55.56%);病灶最大径(5.43±2.03) cm。18个最大病灶(靶病灶)中,5个(5/18,27.78%)呈极低回声、11个(11/18,61.11%)为低回声、2个(2/18,11.11%)为混合回声;10个(10/18,55.56%)内部回声不均匀、8个(8/18,44.44%)内部回声均匀;8个(8/18,44.44%)形态规则、10个(10/18,55.56%)形态不规则;15个(15/18,83.33%)边界清楚、3个(3/18,16.67%)边界不清;CDFI于8个(8/18,44.44%)未见、10个(10/18,55.56%)可见血流信号。CEUS显示,18个靶病变中,1个(1/18,5.56%)无增强、12个(12/18,66.67%)呈周边向中心增强、2个(2/18,11.11%)为中心向周边增强、3个(3/18,16.67%)同步增强;达峰时主要呈低增强(8/18,44.44%)或高增强(7/18,38.89%),部分呈无增强(1/18,5.56%)或等增强(2/18,11.11%);5个(5/18,27.78%)内部造影剂分布均匀、12个(12/18,66.67%)分布不均匀、1个(1/18,5.56%)无造影剂分布;7个(7/18,38.89%)周边呈环状增强、5个(5/18,27.78%)呈树枝状增强,其余呈结节状增强(3/18,16.67%)或无增强(3/18,16.67%);增强后1个(1/18,5.56%)范围增大、17个(17/18,94.44%)范围无明显增大;增强晚期16个(16/18,88.89%)呈低增强、2个(2/18,11.11%)无增强;17个(17/18,94.44%)内见血供、1个(1/18,5.56%)无血供。CEUS正确诊断11例脾淋巴瘤,诊断准确率为(11/18,61.11%),高于常规超声的22.22%(4/18,P=0.020)。结论 CEUS对诊断脾淋巴瘤具有重要临床价值。 |
| 英文摘要: |
| Objective To observe the value of contrast-enhanced ultrasound (CEUS) for diagnosing splenic lymphoma. Methods Eighteen patients with pathologically confirmed splenic lymphoma were retrospectively collected. The routine ultrasound and CEUS manifestations of lesions were observed, and the diagnostic accuracy of these two methods for diagnosing splenic lymphoma were compared. Results Among 18 cases, conventional ultrasound showed single lesion in 8 (8/18, 44.44%) and multiple lesions in 10 cases (10/18, 55.56%). The maximum diameter of lesions was (5.43±2.03) cm. For the largest lesion (target lesion) in 18 cases, 5 (5/18, 27.78%) were found with very low echo, 11 (11/18, 61.11%) with low echo and 2 (2/18, 11.11%) with mixed echo. The internal echo was uneven in 10 lesions (10/18, 55.56%) while uniform in 8 lesions (8/18, 44.44%), 8 (8/18, 44.44%) shaped regularly but 10 (10/18, 55.56%) irregularly, 15 (15/18, 83.33%) with clear and 3 (3/18, 16.67%) with unclear boundaries. CDFI showed blood flow signals in 10 (10/18, 55.56%) but not in 8 lesions (8/18, 44.44%). During CEUS of 18 target lesions, no enhancement was detected in 1 lesion (1/18, 5.56%), peripheral to central enhancement, central to peripheral enhancement and synchronous enhancement was observed in 12 (12/18, 66.67%), 2 (2/18, 11.11%) and 3 lesions (3/18, 16.67%), respectively, which at the peak mainly presented as low (8/18, 44.44%) or high (7/18, 38.89%) enhancement, while no enhancement or equal enhancement was noticed in 1 (1/18, 5.56%) and 2 (2/18, 11.11%) lesions, respectively. Uniform and uneven distribution of contrast agents was found in 5 (5/18, 27.78%) and 12 (12/18, 66.67%) lesions, respectively, while 1 lesion (1/18, 5.56%) without distribution of contrast agents. Annular and dendritic enhancement in peripheral area was observed in 7 (7/18, 38.89%) and 5 lesions (5/18, 27.78%), while nodular enhancement (3/18, 16.67%) or no enhancement (3/18, 16.67%) was noticed each in 3 lesions. The scope enlarged after enhancement in 1 lesion (1/18, 5.56%), while 17 lesions (17/18, 94.44%) did not increase significantly. In the late stage of enhancement, 16 lesions (16/18, 88.89%) showed low enhancement, while 2 (2/18 11.11%) showed no enhancement. Among 18 target lesions, CEUS showed blood supply in 17 lesions (17/18, 94.44%), while no blood supply was found in 1 lesion (1/18, 5.56%). CEUS correctly diagnosed 11 cases of splenic lymphoma, with diagnostic accuracy of 61.11% (11/18), higher than that of conventional ultrasound ([4/18, 22.22%], P=0.020). Conclusion CEUS had important clinical value for diagnosing splenic lymphoma. |
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