超声造影对肝局灶性结节增生与肝腺瘤的鉴别诊断  

Contrast-enhanced Ultrasonographic Differential Diagnosis of Focal Nodular Hyperplasia and Hepatocellular Adenoma

作　　者：李兴华[1] 周平[1] 王利华[1] 田双明[1] 钱滢[1] 陈莉蓉[1] 

机构地区：[1]中南大学湘雅三医院超声科,长沙市410013

出　　处：《中国超声医学杂志》2010年第9期847-849,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声造影(CEUS)在肝局灶性结节增生(FNH)与肝腺瘤(HCA)鉴别诊断中的价值。方法由2名有经验医师回顾性分析经病理学证实的17个肝局灶性结节增生与8个肝腺瘤病灶超声造影图像的增强特点。结果 FNH动脉期71%(12/17)表现为"轮辐状"离心性增强,门静脉期及延迟期消退缓慢,呈等或更为常见的稍高增强(76%),59%(10/17)可以观察到特征性低增强的中央瘢痕。HCA动脉期50%(4/8)表现为快速向心性增强,门静脉期消退较FNH快,延迟期表现为等或更为常见的低增强(63%),37%(3/8)可以全程观察到不增强的出血坏死区。结论 FNH与HCA在CEUS检查中有各自特征性的图像特征,可为其鉴别诊断提供极大帮助。Objective To evaluate the differential diagnosis value of contrast enhanced ultrasonography （CEUS） in focal nodular hyperplasia （FNH） and hepatocellular adenoma （HCA） . Methods CEUS images of histologically proved FNH （n= 17） and HCA （n=8） were retrospectively analyzed. The images analysis was performed by two experienced examiners. Results Twelve （71%） of 17 cases of FNH showed spoke-wheel pattern centrifugal enhancement in arterial phase. During portal venous and late phases, the contrast agent washed out slowly. FNH showed isoechoie or more often hyperechoic （76 %） compared to the surrounding liver parenchyma, and hypoechoic central scars were observed in 10 （59%） of 17 cases. In contrast to FNH, 4 （50%） of 8 cases of HCA showed rapid centripetal enhancement in arterial phase. During portal venous and late phases, the contrast agent washed out rapidly, and isoechoic or more often hypoechoic （63%）, compared to the surrounding liver parenehyma, were observed. Anechoic areas caused by haemorrhage or necrosis were observed in 3 （38%） of 8 cases during the whole process. Conclusions FNH and HCA show different typical enhancement patterns in CEUS, which arc extremely helpful in differentiating.

关 键 词：肝局灶性结节增生 肝腺瘤 超声造影 

分 类 号：R735.7[医药卫生—肿瘤]