肝血管平滑肌脂肪瘤的超声诊断及其与肝血管瘤的鉴别  

Ultrasonographic diagnosis of hepatic angiomyolipoma and differential diagnosis of hepatic angiomyolipoma and hepatic hemangioma

作　　者：唐艳琼[1] 李加伍[2] 凌文武[2] 卢强[2] 罗燕[2] 

机构地区：[1]崇州市人民医院超声心电科,四川成都611230 [2]四川大学华西医院超声科,四川成都610041

出　　处：《生物医学工程与临床》2017年第4期377-380,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的通过对肝血管平滑肌脂肪瘤(HAML)的二维超声、彩色多普勒血流显像特征分析并与肝血管瘤(HH)进行比较,提高对二者的鉴别能力。方法选择经病理证实的HAML患者61例(72个病灶,HAML组),其中男性13例,女性48例;年龄29~53岁,平均年龄41.67岁。同期HH患者70例(87个病灶,HH组),其中男性26例,女性44例;年龄32~56岁,平均年龄46.13岁。对两组病例的二维超声及彩色多普勒血流显像特征如病灶数目、肿块最大径、位置、边界、回声高低、回声均匀程度、网格征及血流丰富程度的差异进行分析。结果二维超声图像HAML与HH在回声均匀程度、网格征方面,差异有统计学意义(P<0.05);在病灶数目、肿块最大径、位置、边界、回声高低方面,差异无统计学意义(P>0.05)。彩色多普勒血流显像,HAML组血流0级36个(50.00%),Ⅰ级12个(16.67%),Ⅱ级20个(27.78%),Ⅲ级4个(5.56%);HH组0级69个(79.31%),Ⅰ级12个(13.79%),Ⅱ级4个(4.60%),Ⅲ级2个(2.30%)。两组差异有显著统计学意义(χ~2=20.34,P<0.001)。结论回声均匀程度、网格征及血流丰富程度对HAML与HH具有鉴别诊断意义。Objective To analyze the hepatic angiomyolipoma（HAML） features by two-dimentional ultrasonography and color Doppler flow imaging, compare with hepatic hemangioma（HH）, and improve discrimination diagnosis between HAML and HH.Methods A total of 61 HAML patients（72 HAML lesions in HAML group, which included 13 males and 48 females; aged 29-53 years old with mean age of 41.67 years old） and 70 HH patients（87 HH lesions in HH group, which included 26 males and44 females; aged 32-56 years old with mean age of 46.13 years old） confirmed by pathological results were enrolled. The differences of image features by two-dimentional ultrasonography and color Doppler flow imaging such as number of lesions,maximum diameter, location, bordery, level and uniformity of echo, grid indication and blood richness between 2 groups were analyzed. Results The differences of HAML and HH in echo uniformity and grid indication between 2 groups were statistical significant（P 〈 0.05）, but there was no statistical significance in number of lesions, maximum diameter, location, bordery and echo level（P 〉 0.05）. By color Doppler flow imaging, the lesion level of blood flow in HAML group were 36 cases（50.00 %）, 12cases（16.67 %）, 20 cases（27.78 %） and 4 cases（5.56 %） for stage 0, Ⅰ, Ⅱ and Ⅲ, respectively. While in HH group there were69 cases（79.31 %）, 12 cases（13.79 %）, 4 cases（4.60 %） and 2 cases（2.30 %） for stage 0, Ⅰ, Ⅱand Ⅲ, respectively, which showed significant differences between 2 groups（χ~2= 20.34, P 〈 0.001）. Conclusion It is demonstrated that echo uniformity, grid indication and extent of blood richness are significant for the differential diagnosis between HAML and HH.

关 键 词：肝血管平滑肌脂肪瘤 肝血管瘤 超声 鉴别诊断 

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]