肝脏上皮样血管平滑肌脂肪瘤实时超声造影征象研究  

Imaging feature of epithelioid angiomyolipomas on real-time contrast-enhanced ultrasonography

作　　者：谢蠡 何年安 叶显俊 章生龙 刘力[1] 胡蕾 Xie Li;He Nian’an;Ye Xianjun(Department of Ultrasound,First Affiliated Hospital,University of Science and Technology of China,Hefei 230001,Anhui Province,P.R.China)

机构地区：[1]中国科学技术大学附属第一医院/安徽省立医院超声医学科,合肥市230001

出　　处：《实用肝脏病杂志》2020年第6期897-900,共4页Journal of Practical Hepatology

摘　　要：目的分析总结肝脏上皮样血管平滑肌脂肪瘤(EAML)的灰阶超声、多普勒超声(CDFI)和超声造影(CEUS)表现。方法回顾性分析我院经手术后组织病理学检查证实的20个EAML患者的临床、灰阶超声、CDFI和CEUS资料。结果20例病灶均为单发,最大径为(49.23±10.3)mm;病灶内部回声为低回声14例(70.0%),高回声3例(15.0%),高低混合不均匀回声3例(15.0%);CDFI显示0级4例(20.0%),I级3例(15.0%),II级10例(50.0%),III级3例(15.0%);阻力指数(RI)为0.46±0.34;CEUS显示所有病灶动脉期都表现为快速高增强,其中13例(86.6%)为整体均匀增强,门静脉期高增强12例(80.0%),等增强2例(13.3%),低增强1例(6.6%),延迟期仍表现为高增强10例(66.6%),等增强4例(26.6%),低增强1例(6.6%)。结论EAML灰阶超声主要表现为低回声,CDFI显示为富血供、低阻力型血流,CEUS主要表现为快进慢退/不退,三者结合或有助于提高诊断的准确性。Objective The purpose of this study was to investigate the gray-scale ultrasound(GSUS),Doppler US(CDFI)and contrast-enhanced ultrasound(CEUS)feature of hepatic epithelioid angiomyolipoma(EAML).Methods A retrospective analysis of 20patients with EAML proven by histopathological examination in our hospital was conducted.The clinical data,GSUS,CDFI,and CEUS werereviewed.Results All the 20 cases had a single hepatic lesion,with maximum tumor diameter of(49.23±10.3)mm;the GSUS showed 70.0%(14/20)of lesions were hypo-echoic,15.0%(3/20)hyper-echoic and 15.0%(3/20)mixed-echoic;50.0%(10/20)of the lesions had striated or branching blood flow and 15.0%(3/20)showed ring-like or arc arterials on Doppler US;the resistance index(RI)was 0.46±0.34;all lesions showed hyperenhancement during arterial phase on CEUS,and 13 cases(86.6%)presenting uniform enhancement;there were 12 cases with high enhancement(80.0%),2 cases(13.0%)withiso-enhancement and 1 cases(6.6%)with low enhancement in the portal vein phase;in the delayed period,10 cases(66.6%)had high enhancement,4 cases(26.6%)had iso-enhancement,and 1 cases(6.6%)had low enhancement.Conclusion The EAML ismainly characterized by hypoechoic,abundant blood flow with low RI,and hyperenhancement in arterial phase and hyper-or iso-enhancement in the portal phase.The combination of GSUS,CDFI and CEUS might improve the correct diagnosis of EAML in clinical practice.

关 键 词：肝脏上皮样血管平滑肌脂肪瘤 多普勒超声 超声造影 特征 

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]