肝脏局灶性结节增生的典型与非典型超声造影表现  

Analysis of the typical and atypical contrast-enhanced ultrasonic features of focal nodular hyperplasia

作　　者：曾丹[1] 咸孟飞 王杨迪 唐小凤[1] 徐作峰[1] 

机构地区：[1]中山大学附属第一医院超声科,广州市510700

出　　处：《临床超声医学杂志》2017年第2期81-84,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金青年科学基金项目(81201104)

摘　　要：目的总结肝脏局灶性结节增生(FNH)的典型与非典型超声造影表现,探讨超声造影对其的诊断价值。方法对205例肝脏局灶性病变患者的307个病灶行超声造影检查,以病理诊断结果为金标准,评价超声造影对FNH的诊断效能,并总结不典型FNH病灶的超声造影增强特征。结果 205例患者(307个病灶)中31例(34个病灶)确诊为FNH。其中31个FNH病灶超声造影表现"高-高-高"或"高-高-等"的典型增强模式,另外3个FNH病灶超声造影表现为"高-低-低"及"等-低-低"的类似恶性病灶的增强模式。超声造影诊断FNH的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为91.2%、97.2%、91.2%、97.2%及96.2%。结论超声造影对FNH具有较高的诊断价值,对少数不典型增强病灶的诊断,需结合肝炎背景、血清甲胎蛋白水平及其他影像学资料,必要时行超声引导穿刺活检或手术切除明确组织病理学诊断。O bjective To summarize the typical and atypical contrast-enhanced altrasound（CEUS）performance of hepatic focal nodular hyperplasia（FNH）,and to evaluate the diagnostic value of CEUS in common benign focal hepatic lesions.Methods CEUS was performed on 307 lesions of 205 focal liver lesion cases,and the pathological results was used as gold standard.The diagnostic value of CEUS was evaluated and enhanced features of CEUS in atypical cases were summarized.Results Among 307 lesions of 205 cases,31 cases with 34 lesions were diagnosed as FNH.31 FNH lesions showed a ＂hyperhyper-hyer＂ and ＂hyper-hyper-iso＂ manifestation as typical enhancement pattern.The enhancement pattern of three FNH lesions were similar to malignant lesions characterized by ＂hyper-lower-lower＂ and ＂iso-lower-lower＂.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of diagnosing FNH by CEUS were 91.2%,97.2%,91.2%,97.2% and 96.7%,respectively.Conclusion CEUS has a high value in the diagnosis of FNH.It is necessary to combine CEUS performance with medical history of hepatitis,AFP and other imaging data in the diagnosis of few lesions with atypical enhancement.And when necessary,ultrasound guided biopsy and surgical resection for histopathological diagnosis should be carried out.

关 键 词：超声检查 造影剂 肝脏局灶性结节增生 非典型表现 

分 类 号：R331.3[医药卫生—人体生理学] R445.1[医药卫生—基础医学]