肝小血管瘤超声造影表现及其诊断  

Diagnostic value and manifestations of contrast-enhanced ultrasound for small hepatic hemangionmas

作　　者：方靓 王文平 陈悦 黄备建 毛枫 董怡 朱正[4] FANG Liang;WANG Wen-ping;CHEN Yue;HUANG Bei-jian;MAO Feng;DONG Yi;ZHU Zheng(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Ultrasound,Huadong Hospital,Fudan University,Shanghai 200040,China;Shanghai Institute of Imaging Medicine,Shanghai 200032,China;Department of Ultrasound,The First People’s Hospital,Taicang 215431,Jiangsu Province,China)

机构地区：[1]复旦大学附属中山医院超声科,上海200032 [2]复旦大学附属华东医院超声科,上海200040 [3]上海市影像医学研究所,上海200032 [4]江苏省太仓市第一人民医院超声科,太仓215431

出　　处：《复旦学报（医学版）》2021年第5期618-623,629,共7页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金面上项目(82071942);上海市临床重点专科项目(shslczdzk03501)。

摘　　要：目的探讨实时超声造影技术诊断肝小血管瘤的价值。方法于2015年6月至2019年7月对手术和病理证实的73例患者共81个肝小血管瘤先后进行常规超声和实时超声造影检查,观察并比较两种检查方法对肝小血管的诊断符合率。结果注射对比剂后,全部81个肝小血管瘤均出现不同程度的增强,其中60个表现为超声造影动脉期周边结节状增强,21个表现为动脉期周边环状增强;所有病灶门脉期及延迟期对比剂均呈现填充的增强过程。64个病灶(79.0%)在门脉期或延迟期呈完全填充,17个病灶(21.0%)呈不完全填充。门脉期及延迟期呈高回声改变者56个,等回声改变者20个,低回声改变者5个。常规超声和超声造影诊断肝小血管瘤的符合率分别为77.8%(63/81)和96.3%(78/81),差异有统计学意义(P<0.05)。结论实时超声造影可以敏感地显示肝小血管瘤的动态增强特征,有助于提高超声诊断符合率。Objective To explore the diagnostic value of real-time contrast-enhanced ultrasound(CEUS)for small hepatic hemangionmas.Methods An analysis was conducted of 81 surgically and pathologically confirmed small hepatic hemangiomas in 73 patients from Jun 2015 to Jul 2019.All the hemangiomas were examined by both conventional ultrasound(CU)and real-time contrast-enhanced ultrasound,and the two modalities were compared for diagnostic accuracy.Results After injection of contrast agent,enhancement was observed in all hemangiomas in the arterial phase,with 60 showing peripheral nodular enhancement and 21 peripheral ring enhancement.Whole-tumor enhancement in the portal phase or delayed phase occurred in 64(79.0%)lesions,and partial tumor enhancement in 17(21.0%)lesions.During portal phase and delayed phase,56 lesions were hyperechoic,20 isoechoic,and 5 hypoechoic.The accuracy rate was 77.8%(63/81)for conventional ultrasound and 96.3%(78/81)for contrast-enhanced ultrasound,the difference was statistically significant(P<0.05).Conclusion Realtime contrast-enhanced ultrasound is able to show the dynamic enhancement patterns of small hepatic hemangionmas with high sensitivity,and its use enhances the diagnostic accuracy.

关 键 词：常规超声 超声造影 肝小血管瘤 增强模式 

分 类 号：R445.1[医药卫生—影像医学与核医学]