肝局灶性炎性病变的超声造影增强表现  

Contrast-enhanced ultrasound manifestations of inflammatory focal liver lesions

作　　者：刘广健[1] 吕明德[2] 谢晓燕[1] 徐辉雄[1] 徐作峰[1] 郑艳玲[1] 梁瑾瑜[1] 黄蓓[1] 王伟[1] 

机构地区：[1]中山大学附属第一医院超声科,广州510080 [2]中山大学附属第一医院肝胆外科,广州510080

出　　处：《中华超声影像学杂志》2007年第10期867-870,共4页Chinese Journal of Ultrasonography

基　　金：广东省科委重点攻关项目（2002C31108）

摘　　要：目的探讨肝局灶性炎性病变超声造影的增强表现。方法采用造影剂SonoVue和对比脉冲序列成像技术对肝脓肿、炎性假瘤、胆管周围炎症、肝结核和真菌感染共58个肝局灶性炎性病灶施行了超声造影检查。观测病灶的增强水平、形态以及随时相变化的特点。结果32个肝脓肿病灶在动脉期呈现高增强、等增强和低增强分别为26个、5个和1个;30个病灶为周边环状增强伴中央无增强,其中22个见内部分隔状增强;20例显示动脉早期病灶所在区域肝组织楔形高增强;26个高增强病灶至门脉期14个、至延迟期共21个消退至低增强;5个等增强病灶至门脉期3个、至延迟期共4个消退至低增强。5例胆管周围炎症者动脉期表现为不均匀高增强（3例）或等增强（2例）,门脉期及延迟期所有病灶减退至低增强。19个炎性假瘤病灶动脉期高增强、等增强和低增强分别为11个、3个和5个,其中12个具有周边环状增强的特点,门脉期及延迟期所有病灶均表现为低增强。1个肝结核病灶和1个真菌感染炎性病灶动脉期均呈不均匀高增强,门脉期及延迟期亦减退至低增强。结论肝脓肿病灶大多数在门脉期为低增强,与欧洲指南所描述的典型表现有所不同。胆管周围炎和局灶性非化脓性炎症病变则表现出在动脉期高增强或等增强后,门脉期及延迟期消退为低增强,与恶性肿瘤的增强模式相似。　Objective To investigate the contrast-enhanced ultrasound （CEUS） features of inflammatory focal liver lesions.Methods A total of 58 focal liver lesions were evaluated using CEUS,including liver abscess,inflammatory pseudotumor,pericholangitis,hepatic tuberculosis and fungal infected focal lesion.CEUS was performed with contrast pulse sequencing （CPS） technique and the contrast agent of SonoVue.The enhancement level,enhancement modality and their changes in different phases were observed.Results In arterial phase,the abscess lesions exhibited hyper-,iso- and hypo-enhancement were 26,5 and 1,respectively.Thirty lesions were irregularly rim enhanced with non-enhanced necrosis areas,and enhanced septa were shown in 22 lesions.Transient arterial phase hypervascularity around abscesses were shown in 20 lesions.Among the 26 lesions with hyper-enhancement in arterial phase,there were 14 and 21 lesions became hypo-enhancement in portal and late phase,respectively.Among the 5 lesions with iso-enhancement in arterial phase,there were 3 and 4 lesions became hypo-enhancement in portal and late phase,respectively.The lesions of pericholangitis with heterogeneous hyper- and iso-enhancement in arterial phase were 3 and 2,respectively.In portal and late phase,all the lesions were heterogeneously hypo-enhanced.As to the inflammatory pseudotumor,the lesions with hyper-,iso- and hypo-enhancement in arterial phase were 11,3 and 5,respectively.Twelve lesions exhibited rim enhancement.In portal and late phase,all the lesions were hypo-enhanced.The hepatic tuberculosis and fungal infected focal liver lesion showed heterogeneous hyper-enhancement in arterial phase and hypo-enhancement in portal and late phase.Conclusions The enhancement features of liver abscess lesion were different from the European guideline,with most of lesions exhibited hypo-enhancement in portal phase.While the enhancement patterns of inflammatory pseudotumor,pericholangitis,hepatic tuberculosis and fungal infected focal liver lesions are usually hyper-

关 键 词：超声检查 造影剂 肝疾病 炎症 

分 类 号：R686[医药卫生—骨科学]