超声造影对原发性肝癌与肝局灶性结节增生的鉴别诊断价值  

Role of Contrast Enhanced Ultrasound in Differential Diagnosis of Primary Hepatocellular Carcinoma and Focal Nodular Hyperplasia

作　　者：徐金锋[1] 熊奕[1] 吴瑛[1] 彭启慧[1] 宋红[1] 冯晓凤[1] 丁志敏[1] 李娟[1] 

机构地区：[1]暨南大学医学院附属第二医院暨深圳市人民医院超声科,深圳518020

出　　处：《华中科技大学学报（医学版）》2006年第6期815-818,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨超声造影在原发性肝癌与肝局灶性结节增生鉴别诊断中的价值。方法经增强CT造影对照,并经手术及病理学检查证实的原发性肝癌23例和肝局灶性结节增生病变10例,采用意大利Bracco公司生产的第二代声学造影剂Sonovue进行超声造影成像,造影时记录肝实质及病灶的充填过程、充盈方式及增强程度。结果肝细胞肝癌和肝局灶性结节增生的超声造影增强模式各有特点,其鉴别要点主要在于病灶的充盈方式及消退时间。原发性肝癌的造影方式呈典型的快进快退型;而局灶性结节增生由于滋养血管在中央疤痕中穿行,其造影方式呈中央向周边逐渐充填,甚至在门脉相和延迟相增强呈等回声,消退时间明显晚于原发性肝癌。结论超声造影能清楚显示原发性肝癌和肝局灶性结节增生的造影充填过程及充填方式,对它们的鉴别诊断具有重要的意义,可作为首选检查方法。Objective To evaluate the value of real-time contrast enhanced ultrasound in differential diagnosis of primary hepatocellular carcinoma and focal nodular hyperplasia(FNH).Methods Twenty-three patients with hepatocellular carcinoma and 10 patients with FNH were examined by contrast enhanced ultrasound.All cases were confirmed histopathologically.Siemens Sequoia 512 color Doppler ultrasound system with contrast pulsed sequence(CPS) software and Sonovue were used.Results Primary hepatocellular carcinoma and FNH had definitely various enhanced pattern on contrast enhance ultrasound.Hepatocellular carcinomas showed a typical hypervascular pattern in the arterial phase and rapid wash-out in the portal phase.A pattern of a radial centrifugal enhanced in the very early arterial phase and a central stellate fibrous scar in portal phase was observed in FNH.Conclusion Contrast enhanced ultrasound is of great value in the differential diagnosis of primary hepatocellular carcinoma and FNH,which can be employed as first-line imaging modality.

关 键 词：原发性肝癌 肝局灶性结节增生 超声检查 造影剂 

分 类 号：R735.7[医药卫生—肿瘤]