摘要
目的探讨肝脏异型增生结节伴癌变(DN-HCC)的超声造影表现特征,提高其诊断正确性。方法回顾性分析经病理证实的60例患者(62个病灶)的临床资料和超声造影图像,其中54个DN-HCC,8个异型增生结节(DN),并根据超声造影肝脏影像学报告及数据系统(CEUS LI-RADS)标准进行分类。结果DN-HCC与DN的超声造影增强类型差异有统计学意义(均P<0.05)。54个DN-HCC病灶在超声造影动脉期具有不同的增强类型,59.3%(32/54)呈高增强,9.3%(5/54)呈局部高增强(结中结),13.0%(7/54)呈同步等增强,18.5%(10/54)呈不均匀低增强。44.4%(24/54)DN-HCC病灶延迟期出现造影剂廓清呈低回声。8个DN病灶中,62.5%(5/8)动脉期呈等增强,25%(2/8)呈不均匀低增强,12.5%(1/8)呈高增强。DN病灶未出现延迟期造影剂廓清。根据CEUS LI-RADS(LR)诊断标准,27.8%(15/54)DN-HCC病灶诊断为LR-5级,46.3%(25/54)DN-HCC病灶诊断为LR-4级,25.9%(14/54)DN-HCC病灶和100%(8/8)DN病灶诊断为LR-3级。将动脉期高增强(包括局部高增强)或者延迟期减退(包括局部减退)作为诊断DN-HCC标准,其敏感性为83.3%,特异性为87.5%,准确性为83.9%。结论动脉期高增强或者延迟期减退的超声造影表现特征对诊断DN-HCC有一定价值。
Objective To investigate the imaging features of dysplastic nodules with a focus of hepatocellular carcinoma(DN-HCC)on contrast-enhanced ultrasound(CEUS)and to improve the diagnostic accuracy.Methods The clinical data of 60 patients and CEUS imaging of 62 hepatic nodules[DN-HCCs,n=54;dysplastic nodules(DN),n=8] pathologically proved were reviewed retrospectively.According to Contrast Enhanced Ultrasound Liver Imaging Reporting and Data System(CEUS LI-RADS),the lesions were categorized.Results Significantly different CEUS patterns between DN-HCCs and DNs were observed(P<0.05).During the arterial phase,54 DN-HCC lesions showed various enhancement patterns [hypervascular,59.3%(32/54);nodule-in-nodule,9.3%(5/54);isovascular,13.0%(7/54)and hypovascular,18.5%(10/54)].Of the 54 DN-HCC lesions,44.4%(24/54)showed washout during the late phase.Of the 8 DN lesions,62.5%(5/8)showed iso-enhancement during the arterial phase,25%(2/8)showed hypo-enhancement,and 12.5%(1/8)showed hyper-enhancement.No DN lesion showed washout during the late phase.According to CEUS LI-RADS(LR)algorithm,27.8%(15/54)DN-HCCs were LR-5,46.3%(25/54)DN-HCCs were LR-4,25.9%(14/54)DN-HCCs and 100%(8/8)DNs were LR-3.Regarding hyper-enhancement(including local hyper-enhancement)during the arterial phase or hypo-enhancement(including local hypo-enhancement)during the late phase as the diagnostic standard of DN-HCC,the diagnostic sensitivity,specificity and accuracy value were 83.3%,87.5% and 83.9%,respectively.Conclusions The imaging features of hyper-enhancement during the arterial phase or hypo-enhancement during the late phase on CEUS are useful to diagnose DN-HCCs.
作者
范培丽
王文平
曹佳颖
毛枫
季正标
董怡
韩红
李超伦
陈伶俐
刘亚岚
Fan Peili;Wang Wenping;Cao Jiaying;Mao Feng;Ji Zhengbiao;Dong Yi;Han Hong;Li Chaolun;Chen Lingli;Liu Yalan(Department of Ultrasound,Zhongshan Hospital & Shanghai Institute of Medical Imaging & Institute of Ultrasound in Medicine and Engineering,Fudan University,Shanghai 200032, China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2018年第12期1042-1047,共6页
Chinese Journal of Ultrasonography
基金
国家自然科学基金面上项目(81571675,81571676)
上海市医学领军人才项目.
关键词
超声造影
肝肿瘤
异型增生结节
Contrast-enhanced ultrasound
Liver neoplasms
Dysplastic nodules
