肝泡型棘球蚴病和肝恶性肿瘤的超声鉴别诊断  

Ultrasonic differential diagnosis of patients with liver alveolar hydatid disease and hepatic malignant tumor

作　　者：周文蓉[1] 张海[1] 丁海耀[1] 汪金鑫 

机构地区：[1]青海红十字医院超声科,西宁810000

出　　处：《中华地方病学杂志》2017年第6期448-451,共4页Chinese Journal of Endemiology

摘　　要：目的 探讨超声造影在肝泡型棘球蚴病与肝恶性肿瘤鉴别诊断中的价值。方法 收集2010年3月至2013年9月就诊于青海红十字医院超声科的36例肝泡型棘球蚴病患者和31例肝恶性肿瘤患者临床资料，进行回顾性分析，比较肝泡型棘球蚴病与肝恶性肿瘤的灰阶超声和超声造影检查表现特征。结果 ①灰阶超声：36例肝泡型棘球蚴病患者，共发现病灶49个，病灶最大面积（5.06 ± 2.46）cm2，边界尚清，内部为较低回声、欠均匀；31例肝恶性肿瘤患者病灶最大面积为（7.29 ± 5.83）cm2，边界欠清，内部回声为较低回声。②超声造影：肝泡型棘球蚴病49个病灶内部三期均未见造影剂充盈，病灶周边呈环状增强；肝恶性肿瘤动脉期表现为高增强，门脉期及延迟期表现为等增强或低增强，异常灌注区清晰。结论 肝泡型棘球蚴病超声造影表现有别于肝恶性肿瘤，超声造影技术在肝泡型棘球蚴病和肝恶性肿瘤的鉴别诊断上有重要价值。bjective To investigate the value of ultrasound contrast in differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor. Method Totally 36 cases of liver alveolar hydatid disease and 31 cases of hepatic malignant tumor were retrospectively analyzed, who visited the Ultrasound Department of Qinghai Red Cross Hospital from March 2010 to September 2013, the performance characteristics of gray-scale ultrasound and contrast-enhanced ultrasound （CEUS） on hepatic malignant tumor and liver alveolar hydatid disease were compared. Results Gray-scale sonography of 36 liver alveolar hydatid diseases showed clear boundary, heterogeneous hypoechoic nodules, and the maximum area was （5.06 ± 2.46） cm2 in 49 lesions; gray-scale sonography of 31 hepatic malignant tumors showed unclear boundary, hypoechoic nodules, and the maximum area was （7.29 ± 5.83） cm2. CEUS of liver alveolar hydatid disease showed non-enhancement in three phases, and rim enhancement was seen synchronized with the liver parenchyma. CEUS of hepatic malignant tumor showed hyper-enhancement in arterial phase, equal-enhancement or hypo-enhancement in portal phase and delayed phase, and abnormal perfusion areas were clear. Conclusion Liver alveolar hydatid disease is different in the performance of CEUS from hepatic malignant tumor, CEUS has a great value in the differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor.

关 键 词：超声造影 肝泡型棘球蚴病 原发性肝癌 肝转移癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R532.32[医药卫生—诊断学] R735.7[医药卫生—临床医学]