肝上皮样血管内皮瘤的常规超声及超声造影特征分析  

Ultrasonographic Features of Hepatic Epithelioid Hemangioendothelioma on B-mode and Contrast-enhanced Ultrasound

作　　者：凌文武[1] 罗燕[1] 林玲[1] 马琳[1] 邱婷婷[1] 杨蕗璐[1] 卢强[1] 

机构地区：[1]四川大学华西医院超声科,成都610041

出　　处：《四川大学学报（医学版）》2017年第4期595-599,共5页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.81501488);成都市科技局项目(No.2014-HM01-00021-SF)资助

摘　　要：目的探讨肝上皮样血管内皮瘤(hepatic epithelioid hemangioendothelioma,HEHE)的常规超声及超声造影(CEUS)表现特征。方法回顾性分析2012年1月至2016年9月在我院经手术或肝穿活检病理证实为HEHE的17例患者资料,对患者的一般临床资料、常规超声及超声造影的声像图特征进行分析。结果17例HEHE患者中,男7例,女10例,年龄23~69岁,平均年龄(42.88±13.95)岁。常规超声显示11例(11/17,64.7%)为多发病灶,其中10例累及全肝,6例(6/17,35.3%)为单发;15例(15/17,88.2%)病灶位于肝包膜下;病灶平均直径(3.93±2.23)cm;声像图上表现为低回声、混合回声、高回声病灶分别为13例(13/17,76.5%)、3例(3/17,17.6%)、1例(1/17,5.9%);10例(10/17,58.8%)病灶边界清楚,7例(7/17,41.2%)边界不清;16例(16/17,94.1%)病灶的形态规则。7例行超声造影检查,5例(5/7,71.4%)动脉期表现为环状高增强;2例(2/7,28.6%)为整体高增强,内部强化不均匀。所有病例(7/7,100%)在门脉期及延迟期均表现为低增强。结论声像图上表现为肝包膜下多发、形态规则的低回声肿块要考虑到HEHE的可能,CEUS有助于诊断及鉴别诊断。Objective To investigate the ultrasonographic features of hepatic epithelioid hemangioendothelioma （HEHE） on B-mode and contrast-enhanced ultrasound （CEUS）. Methods From January 2012 to September 2016, 17 patients with surgery or biopsy confirmed HEHE were retrospectively analyzed for their clinical history, ultrasonographic data of B-mode ultrasound and CEUS characteristics. Results The mean age of the 17 patients was （42.88±13.95） yr. （range 23-69 yr. ）. On B-mode ultrasound, 6 case （6/17,35.3%） were single lesion, while 11 case （11/17,64.70% ） had multiple lesions, of which 10 cases involved the global liver. There were 88.2% of lesions （15/17） located underneath the liver capsule, and 94. 1% of lesions （16/17） with regular shape. The mean diameter of the lesions was （3. 93±2. 23） cm. The lesions appeared as hypoechoic （13/17, 76.5%）, hyperechoic （1/17,5.9%） and mixed-echoic （3/17,17.6%）. 7 patients underwentCEUS, 5 of them （5/ 7, 71.4%） showed a rim-like hyperenhancement in arterial phase while the other 2 presented overall hyperenhancement of the lesions with uneven perfusion inside. All cases demonstrated hypoenhancement in portal and delay phases. Conclusion Multiple subcapsular hypoechoic focal liver lesions with regular shape remind of the possibility of HEHE. CEUS could provide considerable value in its diagnosis.

关 键 词：肝脏 上皮样血管内皮瘤 超声造影 

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