超声造影在肝内胆管癌与肝脏炎性假瘤鉴别诊断中的应用  

Application of contrast-enhanced ultrasound in differential diagnosis of intrahepatic cholangiocarcinoma and hepatic inflammatory pseudotumor

作　　者：薛海燕 孔文韬[1] 沈海云 金志斌[1] 韩浩[1] 吴敏[1] XUE Haiyan;KONG Wentao;SHEN Haiyun;JIN Zhibin;HAN Hao;WU Min(Department of Ultrasound,Nanjing Drum Tower Hospital,Nanjing University,Nanjing 210009,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院超声诊断科,江苏南京210009

出　　处：《肿瘤影像学》2020年第5期483-488,共6页Oncoradiology

基　　金：国家自然科学基金(81671701);“十三五”南京市卫生青年人才培养工程资助(QRX17011)。

摘　　要：目的:探讨肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)与肝脏炎性假瘤(inflammatory pseudotumor,IPT)的超声造影(contrast-enhanced ultrasound,CEUS)鉴别要点。方法:分析50例ICC病灶和45例IPT病灶的血清学肿瘤标志物、常规超声及CEUS图像,探讨两种病变的鉴别诊断特征。结果:血清学肿瘤标志物中,糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)升高在两组间差异有统计学意义(P<0.05);常规超声中,病灶内部回声均匀性、内部有无血流信号及周边有无胆管扩张在两组间差异有统计学意义(P<0.05);CEUS中,动态增强模式“快进快退”在两组间差异有统计学意义(P<0.05);动脉期病灶呈三种增强方式:周边环状增强、整体不均匀增强和整体均匀增强,两组间增强方式差异有统计学意义(P<0.05)。结论:CEUS对ICC与IPT的鉴别诊断可提供更多的信息,具有一定的应用价值。Objective:To investigate the differential features between intrahepatic cholangiocarcinoma(ICC)and hepatic inflammatory pseudotumor(IPT)by contrast-enhanced ultrasound(CEUS).Methods:The serum tumor maker,conventional ultrasound and CEUS images of 50 ICC lesions and 45 IPT lesions were analyzed,and the the differential diagnostic features of them were discussed.Results:There were significant differences in the increase of carbohydrate antigen 19-9(CA19-9)between the two groups(P<0.05).The conventional ultrasound features,including homogeneity of internal echo,blood flow signal and biliary dilatation,were statistically significant between the two groups(P<0.05).Enhanced contrast dynamic mode,rapid hyperenhancement in the arterial phase and rapid wash out was significant differences between the two groups(P<0.05).There were three modes of enhancement in the arterial phase of lesions:peripheral ring enhancement,global heterogeneous enhancement and global homogeneous enhancement,and the difference in enhancement modes between the two groups was statistically significant(P<0.05).Conclusion:CEUS can provide more information for differential diagnosis of ICC and IPT lesions,which has certain diagnostic value.

关 键 词：肝内胆管癌 肝脏炎性假瘤 超声造影 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]