脂肪肝背景下肝小血管瘤的超声造影诊断研究  

Evaluation on the diagnosis of hepatic hemangioma with fatty liver by contrast-enhanced ultrasound

作　　者：王丽[1] 吴雅峰[1] 刘桂梅[1] 蒋涛[2] 于泽兴 唐华[1] 姜晓红[1] 

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京100020 [2]首都医科大学附属北京朝阳医院CT室,北京100020

出　　处：《中华超声影像学杂志》2008年第12期1051-1053,共3页Chinese Journal of Ultrasonography

摘　　要：目的应用超声造影观察不同回声型小血管瘤的灌注及其回声变化规律，探讨超声造影对重度脂肪肝患者伴发肝血管瘤的诊断价值。方法对25例常规超声不能明确定性或CT检查漏诊的典型脂肪肝伴疑诊肝小血管瘤患者的27个病灶，采用超声造影进一步检查，并与增强CT或MRI结果比较。结果注射造影剂后平均（17．0±4．4）s病灶开始出现回声增强，12个（12／17）直径≤2cm的病灶呈现整体均匀或不均匀增强，边界较清晰，回声明显强于周围脂肪肝组织背景或呈现强回声“淹没征”；8个（8／10）直径〉2．0cm的病灶表现由周边向中心呈“片状”或“环状”不规则增强；1例CT未显示的直径1．3cm的弱回声病灶注射造影剂后12s出现边缘增强，持续至6min肝实质期开始消退。直径〉2cm与≤2cm病灶超声造影剂增强时间差异无统计学意义。结论超声造影有助于提高脂肪肝背景下伴发肝小血管瘤的定性诊断。Objective To evaluate the value of differential diagnosis of hepatic hemangioma with farty liver by observing the echoes of the small blood vessels of hemangioma via the harmonic angiographic ultrasounography. Methods Ultrasound contrast agent SonoVue and real time contrast tuned imaging （CnTI） were used for twenty-seven lesions from twenty-five typical fatty liver patients with unconfirmed hepatic hemangioma by conventional methods of ultrasound or misdiagnosed by CT. The results were compared with CT or MRI method. Results The contrast enhancement patterns were obtained at mean （17.0±4.4） s after the administration of the contrast agents. Twelve of 17 foci （diameter≤2 cm） demonstrated even or uneven integral echo enhancement with well-defined margins, which were obviously stronger than their surrounding fatty liver tissues or even showed so strong echoes that we called submerged image. The other 8 of 10 foci （diameter〉2.0 cm） showed patchy or ring irregular enhancement from the periphery to the central lesions. One ease with a diameter of 1. 3cm showing atypical image by the CT method began to show a hyper echoic focal lesion at the 12th second after the injection of the ultrasound agents and lasted 6 minutes before the echo disappeared （liver parenchyma phase）. However, the mean duration of contrast-enhancement in the foei with the diameter of less than 2 cm was not significantly different from that of the loci with the diameter more than 2 cm. Conclusions Contrast-enhanced ultrasound may be a better technique for the quantitative diagnosis of hepatic hemangioma accompanied with fatty liver.

关 键 词：超声检查 微气泡 脂肪肝 血管瘤 

分 类 号：R686[医药卫生—骨科学]