对比超声造影与上腹部增强CT检查对肝血管瘤的诊断效能  

Comparison on Diagnostic Efficacy of Contrast-enhanced Ultrasonography and Upper Abdominal Enhanced CT for Hepatic Hemangiomas

作　　者：敬容 刘剑[2] JING Rong;LIU Jian(Department of Ultrasonography,Sport Hospital Attached to Chengdu Sport Institute,Chengdu 610041,Sichuan Province,China;Department of Radiology,Sport Hospital Attached to Chengdu Sport Institute,Chengdu 610041,Sichuan Province,China)

机构地区：[1]成都体育学院附属体育医院超声检查科,四川成都610041 [2]成都体育学院附属体育医院放射科,四川成都610041

出　　处：《中国CT和MRI杂志》2021年第3期90-91,158,共3页Chinese Journal of CT and MRI

基　　金：四川省科技厅科技支撑项目(2016SZ0723)。

摘　　要：目的探讨超声造影(CEUS)与上腹部增强CT检查对肝血管瘤(HH)的诊断效能。方法选取2016年10月至2017年12月于我院就诊治疗的78例HH患者作为研究对象,以手术病理学检查结果为标准,比较不同影像学检查对HH的诊断符合率,并分析HH在不同影像学检查中的图像表现。结果 CEUS与增强CT对HH的诊断符合率比较(89.74%vs 89.14%),差异无统计学意义(P>0.05);CEUS与增强CT检查对直径≥4cm的HH阳性检出率比较,差异无统计学意义(P>0.05),但对于直径<4cmHH的阳性检出率CEUS检查显著高于增强CT检查(P<0.05)。CEUS检查动脉期表现呈周边明显强化,门脉期病灶中心呈向心性缓慢充填式增强;回声较周围高,延迟期呈自周边向中心缓慢充填式增强,CT平扫显示所有病灶均呈现为边界清晰的圆形或卵圆形低密度影,增强动脉期呈现边缘环形或结节状强化,门静脉期部分病灶密度高于同层肝实质,呈明显强化,延迟期部分表现为等密度或稍低密度。即HH在CEUS和增强CT中均表现为增强后病灶早期呈周边强化,随后呈向心性填充。结论超声造影与上腹部增强CT检查对HH均有一定的显示,但超声造影对于直径较小的HH检出率较高,故将超声造影和增强CT相结合更有利于提高HH的诊断正确率。Objective To investigate the diagnostic effica cy of contrast-enhanced ultrasonography(CEUS) and upper abdominal enhanced CT for hepatic hemangiomas(HH).Methods 78 patients with HH who were treated in our hospital from October 2016 to December 2017 were selected as subjects.The results of surgical pathology were used as criteria to compare the diagnostic accuracy of different examinations for HH.Imaging features of the HH in imaging examinations were analyzed.Results There was no significant difference between the CEUS and enhanced CT in the diagnose accordance rate for HH(89.74% vs 89.14%)(P>0.05).There was no significant difference between the CEUS and enhanced CT in the positive detection rate of HH with diameter above 4 cm(P>0.05).However,the positive detection rate of CEUS examination for HH with diameter<4 cmHH was significantly higher than that of enhanced CT examination,and the difference was significant(P<0.05).CEUS examination showed obvious enhancement in the arterial phase,in portal vein phase,the center of the lesion showed a centripetal slow packed enhancement,the echo was higher than counterpart of the surrounding.In the delayed phase,it showed a slow packed enhancement from the periphery to the center.CT scan showed that all lesions showed a round or oval low-density shadow with clear boundary,which showed enhancement with ring-shaped or nodular edge in the a rterial phase of ea rly enhancement.The density of some lesions in the portal vein phase was higher than that in the same layer of liver parenchymal tissue,which showed significantly enhancement.The tissue density was significa ntly enhanced,and it showed an equal density or a slightly lower density in the 4 th part of the delayed phase.That was,HH showed enhancement in both CEUS and enhanced CT,and the lesion was peripherally enhanced in ea rly stage,followed by centripetal filling.Conclusion Contrast-enhanced ultrasonography and upper abdominal enhanced CT examination can show HH to some extent,but contrast-enhanced ultrasonography has a hi

关 键 词：超声造影 增强CT 肝血管瘤 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]