肝血管平滑肌脂肪瘤超声造影、增强CT特点及其与病理分型的关系  

Hepatic angiomyolipoma: correlation of contrast-enhanced ultrasound, contrast-enhanced CT and pathologic findings

作　　者：张溢[1] 李锐[1] 张晓航[1] 陈伟[1] 李传明[1] 段光杰[1] 郭燕丽[1] 唐春霖[1] 陈朝晖[1] 

机构地区：[1]第三军医大学西南医院超声科,重庆400038

出　　处：《中华医学超声杂志（电子版）》2013年第11期54-58,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的比较肝血管平滑肌脂肪瘤(HAML)超声造影与增强CT增强模式差异,并探讨其与病理分型的关系。方法回顾性分析2006年1月至2012年12月第三军医大学西南医院30例经手术或者穿刺确诊为HAML患者超声造影及增强CT术前诊断结果及影像学表现,并与其病理学检查结果进行对照分析。本组病灶超声造影典型表现的比例与增强CT典型表现的比例采用Fisher确切概率法进行比较。结果本组30例HAML患者共31个病灶,17个病灶常规超声表现为不均质高回声;20个病灶超声造影表现为3个时相不均匀强化的HAML典型超声造影表现,余11个病灶超声造影增强模式不典型。17个病灶CT平扫示瘤内含有脂肪密度;7个病灶增强CT表现为3个时相不均匀强化的典型增强CT表现;余24个病灶增强模式不典型。31个病灶超声造影显示典型表现的比例(64.5%)高于增强CT(22.6%),且差异有统计学意义(P=0.002)。11个混合型HAML病灶中,7个病灶超声造影表现典型增强模式,2个呈典型增强CT表现;10个平滑肌细胞为主型HAML病灶中,6个病灶超声造影表现典型增强模式,2个呈典型增强CT表现;8个成熟脂肪细胞为主型HAML病灶中,6个病灶超声造影表现典型增强模式,3个呈典型增强CT表现。结论常规超声联合超声造影能够显示多数HAML的回声和血流灌注特点,且HAML的超声造影与增强CT表现与病理分型有关。Objective To compare the features of contrast enhanced ultrasound （CEUS） and contrast-enhanced computed tomography （CECT） of hepatic angiomyolipoma （HAML）, and to explore their relationship with pathologic findings, Methods Thirty patients with 31 resected or punctured and pathologically proved hepatic angiomyolipomas in Southwest Hospital of Third Military Medical University from January 2006 to December 2012 were selected in this retrospective study. CEUS and CECT features were evaluated and analyzed with pathology findings in 30 patients with HAML preoperatively. The proportion of typical performance by CEUS compared exact propability. Results Seventeen lesions were with CECT in this group was analyzed with Fisher inhomogeneous hyperechoic under conventional ultrasound observation. Twenty lesions demonstrated typical imaging characteristics by CEUS, eleven lesions showed atypia CEUS imaging characteristics. There were seventeen lesions on CT indicates the presence of fat. Seven lesions demonstrated typical imaging characteristics by CECT, twenty-four lesions presented atypical CECT imaging characteristics. The proportion of showing typical imaging characteristics by CEUS was higher than by CECT （64.5% vs 22.6%, P=0.002）. Among the eleven mixed type HAML lesions, seven lesions showed typical CEUS imaging characteristics and two lesions demonstrated typical CECT imaging characteristics. In the ten myomatous type HAML lesions, six lesions displayed typical CEUS imaging characteristics and two lesions revealed typical CECT imaging characteristics. Among the eight lipomatous type HAML lesions, six lesions showed typical CEUS imaging characteristics and three lesions displayed typical CECT imaging characteristics. Conclusions Conventional ultrasound combining with CEUS can demonstrate the echoic and blood perfusion characteristics of HAML in most cases. The features of CEUS and CECT were varied in different histological types.

关 键 词：肝肿瘤 超声检查 造影剂 体层摄影术 X线计算机 病理学 

分 类 号：R735.7[医药卫生—肿瘤]