肝背景对肝内局灶性病变超声造影的影响  

Influence of Hepatic Background in Diagnosing Hepatic Focal Nodules Using Contrast-enchancement Ultrasound

作　　者：林振湖[1] 林礼务[1] 薛恩生[1] 俞丽云[1] 高上达[1] 何以敉[1] 林学英[1] 

机构地区：[1]福建省福建医科大学附属协和医院超声科福建省超声医学研究所,福州市350001

出　　处：《中国超声医学杂志》2008年第5期434-437,共4页Chinese Journal of Ultrasound in Medicine

基　　金：福建省科技厅重点资助项目(No.2000Z138)

摘　　要：目的探讨肝背景对肝内局灶性病变超声造影的影响。方法113例肝局灶性病变根据肝背景分为正常肝实质组(A组,45例)、代偿性肝硬化组(B1组,22例)、失代偿性肝硬化组(B2组,24例)与脂肪肝组(C组,22例)。其中,肝癌69例(A组23例、B1组22例、B2组24例),血管瘤30例(A组16例、C组14例),局灶性结节性增生(FNH)14例(A组6例、C组8例)。对比观察不同肝背景以及不同肝背景下同性质病灶的增强持续时间;对比观察不同肝背景下同性质病灶的增强模式。结果4组增强持续时间中,A组与B1组的没有明显差异(P>0.05),B2组的最短,C组的最长。不同肝背景下同性质病灶的增强持续时间无明显差异(P均>0.05)。A组23例HCC与B1组22例HCC分别有87.0%(20/23)与95.5%(21/22)延迟相均呈低增强,而B2组24例HCC中却有83.3%(20/24)延迟相呈等增强甚至高增强。C组14例HCH与8例FNH延迟相均呈低增强。结论脂肪肝、肝硬化背景与正常肝背景的增强持续时间不同,可使病灶延迟相表现不典型而改变病灶增强模式,诊断时需重视肝背景的影响。Objective To probe the influence of hepatic background in diagnosing hepatic focal nodules using contrast-enchancement ultrasound （CEUS） .Methods A total of 113 in-patients with hepatic leisions underwent CEUS and were admited. Four categories were classified on the basis of hepatic background： the normal hepatic backgroud （group A, 45 cases）, the compensatory cirrhosis backgroud （group B1, 22 cases） ; decompensated cirrhosis background （group B2, 24 cases）, fatty hepatic backgroud （group C, 22 cases）. Among the 113 hepatic patients, 69 cases were hepatic cell carcinoma （HCC） （23 cases in group A, 22 cases in group Bl, 24 cases in group C）; 30 cases were hemangioma （MG） （16 cases in group A, 14 cases in group C） ; 14 cases were follicular nodular hyperplasia （FNH） （6 cases in group A, 8 cases in group C）. The lasting enhancement time and enhancement mode of different hepatic background and hepatic leisions with the same quality under different hepatic backgound were compared. Results Among the four groups the lasting enhancement time in A group had no difference compared with that of B1 group, B2group and was the shortest, while that of the C group was the longest. The lasting enhancement time of hepatic leisions with the same quality under different hepatic background had no differences compared with each other. 87.0% （20/23/ of HCC with the normal hepatic background and 95.5% （21/22/ of HCC with the compensatory hepatic cirrhosis presented equivalent even hyperechoic enhancement in the delayed phase. However, 83.3% （20/24）of HCC with decompensated cirrhosis background presented equivalent even hyperehcoic enhancement in the delayed phase; 14 HMG and 8 FNH with fatty hepatic background appeared hypoechoic enhancement in the delayed phase. Conclusions The lasting enhancement time of both hepatic cirrhosis background and fatty hepatic backgroud were different from that of the normal hepatic background. , which make the enhancement mode of hepatic leisions atypi

关 键 词：超声造影 肝背景 脂肪肝 肝硬化 肝局灶性病变 

分 类 号：R445.1[医药卫生—影像医学与核医学]