超声造影鉴别诊断脂肪肝背景下局灶性低回声小病灶  

Contrast enhanced ultrasonography in diagnosing small focal hypoechoic lesions with fatty liver

作　　者：周柱玉[1] 沈理[1] 张海兵[2] 周俊宇[1] 陆殿元[1] 蔡建荣[1] 赵丽英[1] 顾娟[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院超声科,上海202150 [2]上海交通大学医学院附属新华医院崇明分院放射科,上海202150

出　　处：《中国介入影像与治疗学》2011年第3期231-235,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨CEUS鉴别诊断脂肪肝背景下低回声小病灶(直径≤3 cm)的价值。方法回顾性分析48例脂肪肝患者共54个低回声小病灶的常规超声及CEUS表现。结果 54个低回声小病灶中,病理诊断恶性病灶15个,包括肝细胞癌5个,胆管细胞癌2个,转移癌8个,均表现为快进快出型增强;病理和综合诊断良性病灶39个,13个表现为快进慢出型,3个慢进慢出型,17个同步强化型,5个为无强化型,仅1个表现为快进快出型。实性良、恶性病灶的峰值时间及始退时间差异有统计学意义(P<0.05),而始增时间无显著差异(P>0.05)。CEUS诊断脂肪肝背景下低回声小病灶的符合率为92.59%(50/54),而常规超声诊断符合率为62.96%(34/54),差异有统计学意义(P<0.05)。结论 CEUS能为鉴别脂肪肝背景下良、恶性低回声小病灶提供重要诊断依据,具有重要临床应用价值。Objective To observe the value of CEUS in differential diagnosis of focal hypoechoic small lesions（diameter≤3 cm） within fatty liver.Methods Imaging features of routine ultrasonography and CEUS of 48 patients with 54 hepatic lesions within fatty liver were analyzed retrospectively.Results Fifteen of 54 lesions were malignant,including 5 hepatocellular carcinomas,2 cholangiocellular carcinomas and 5 metastases.The enhancement type of the malignancies was rapid washin and washout.Thirty-nine lesions were benign.The enhancement type was rapid washin and slow washout in 13 lesions,slow washin and washout in 3,simultaneously enhanced in 17,while 5 lesions showed no enhancement and only 1 lesion showed rapid washin and washout type.The time-to-peak（TTP） and time-to-fade（TTF） between benign and malignant lesions were statistically different（P0.05）,while the arrival time（AT） between them were not statistically different（P0.05）.The diagnostic coincidence of CEUS was 92.59%（50/54）,while that of routine US was 62.96%（34/54,P0.05）.Conclusion CEUS is of great value in diagnosis and differential diagnosis of focal hypoechoic small lesions within fatty liver.

关 键 词：超声检查 介入性 脂肪肝 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]