肝脏局灶性结节增生的超声造影表现及相关因素  

Contrast enhanced ultrasonic features and related factors of focal nodular hyperplasia

作　　者：陈立达[1,2] 王伟[1,2] 刘广健[1,2] 吕明德[1,2,3] 徐作峰[1,2] 谢晓燕[1,2] 王燕[1,2] 陈勉妮[1,2] 

机构地区：[1]中山大学附属第一医院超声科 [2]中山大学超声诊断与介入超声研究中心 [3]中山大学附属第一医院肝胆外科,广东广州510080

出　　处：《中国医学影像技术》2013年第9期1473-1476,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(30901384、81271576);广东省医学科研基金(B2012094)

摘　　要：目的探讨肝脏局灶性结节增生(FNH)的CEUS表现,分析其相关因素。方法对49例经病理确诊的FNH患者行CEUS检查,观察三期增强模式、离心性增强、轮辐状动脉、供血动脉和中央瘢痕,并分析上述各征象与病灶大小及肝脏背景的关系。结果 49例中,三期最常见的增强模式分别为动脉期高增强(45/49,91.84%)、门脉期等增强(25/49,51.02%)及延迟期等增强(21/49,42.86%);离心性增强27例(55.10%),轮辐状血管14例(28.57%),可见供血动脉33例(67.34%),中央瘢痕13例(26.53%)。在≤3cm和≤5cm的FNH中分别有15例(15/21,71.43%)和25例(25/38,65.79%)检出离心性增强,在≤3cm的FNH中未见中央瘢痕,但不同大小的FNH中轮辐状动脉(P=0.78)和供血动脉(P=0.62)的检出率差异无统计学意义。不同肝脏背景的FNH中,4种CEUS典型征象的检出率差异均无统计学意义(P均>0.05)。结论 FNH最常见的三期增强模式为"高-等-等";离心性增强常见于较小的FNH,而较大FNH多可见中央瘢痕。Objective To investigate CEUS features and the related factors of focal nodular hyperplasia （FNH）. Methods Totally 49 patients with histologically proven FNH underwent CEUS. The enhancement level, centrifugal filling, spoke- wheel arteries, feeding artery and central scar were observed, and the relation with lesion size and liver background were analyzed. Results The most common enhancement levels of FNH in arterial, portal and late phase was hyper-enhancing （45/49, 91.84%）, iso-enhancing （25/49, 51.02%） and iso-enhancing （21/49, 42.86%）, respectively. Among 49 FNHs, centrifugal filling, spoke-wheel arteries, feeding artery and central scar were detected in 27 （55.10%）, 14 （28.57%）, 33 （67.34%） and 13 （26.53%） cases, respectively. Centrifugal filling was detected in 15 （15/21, 71.43%） and 25 （25/38, 65.79~） FNHs 3 cm and 5 cm or less in size, respectively. The central scar was only found in FNH larger than 3 era. No statistically significant difference was observed between lesion size and detection rate of spoke-wheel arteries or feeding artery, nor between liver background and detection rate of these typical features. Conclusion The most common enhancement pattern of FNH is ＂hyper-iso-iso＂. CEUS is valuable in characterizing centrifugal filling signs in small FNHs or central scar in large FNHs.

关 键 词：局灶性结节增生 病理学 超声检查 造影剂 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]