摘要
目的:观察肝脏局灶性病变的实时超声造影(contrast-enhanced ultrasound,CEUS)表现,评价CEUS在肝脏局灶性病变定性诊断中的应用价值。方法:回顾并分析行CEUS检查的50例肝脏局灶性病变患者(62个病灶)的临床资料,分析其CEUS特征。结果:以穿刺标本病理学检查结果为标准,CEUS检出62个肝局灶性病变诊断符合率如下:肝细胞肝癌(hepatocellular carcinoma,HCC)85.7%,胆管细胞性肝癌(hepatic cholangiocarcinoma,CC)100.0%,转移性肝癌(metastatic hepatic carcinoma,MLC)100.0%,肝血管瘤94.1%,局灶性增生结节(focal nodular hyperplasia,FNH)92.3%,肝硬化结节100.0%,肝局灶性脂肪缺损100.0%,肝局部炎性病变100.0%。1个HCC误诊为肝血管瘤,1个肝血管瘤和1个FNH均误诊为HCC。恶性病变组的始增时间早于良性病变组,差异有统计学意义(P<0.05)。恶性病变组的达峰时间、始消时间明显早于良性病变组,持续时间明显小于良性病变组,差异有统计学意义(P<0.01)。肝脏良恶性局灶性病变大部分具有典型的增强模式。结论:CEUS通过提供肝内局灶性病变的血流灌注特征,清晰反映出不同性质病变的造影增强特点,对肝脏良恶性病变的鉴别准确率高,具有较高的实用价值。
Objective:To observe the real-time contrast-enhanced ultrasound(CEUS)findings of focal liver lesions and to evaluate the value of CEUS in the qualitative diagnosis of focal liver lesions.Methods:The results of real-time CEUS in 62 lesions of 50 patients with focal liver lesions were analyzed retrospectively.The sonographic features of CEUS were analyzed.Results:According to the diagnostic results of puncture pathology,the diagnostic coincidence rate of 62 focal hepatic lesions detected by CEUS was as follows:hepatocellular carcinoma(HCC)85.7%,hepatic cholangiocarcinoma(CC)100.0%,metastatic hepatic carcinoma(MLC)100.0%,hepatic hemangioma 94.1%,focal nodular hyperplasia(FNH)92.3%,cirrhotic nodule 100.0%,focal fat defect of liver 100.0%,local inflammatory lesions of the liver 100.0%.One HCC was misdiagnosed as hepatic hemangioma,one hepatic hemangioma and one FNH of the liver were misdiagnosed as HCC.The starting time of enhancement of malignant lesions was earlier than that of benign lesions,and the difference was statistically significant(P<0.05).The peak time and time to begin to fade of malignant lesions was significantly earlier than benign lesions and the duration was significantly less than that in the benign lesions(P<0.01).The majority of benign and malignant focal lesions in the liver have typical enhancement patterns.Conclusion:By providing the blood perfusion features of intrahepatic focal lesions,CEUS can clearly reflect the contrast-enhanced characteristics of different lesions.Therefore,CEUS has high accuracy and high application value in the differential diagnosis of benign and malignant lesions.
作者
沈以松
罗鑫
SHEN Yisong;LUO Xin(Department of Ultrasonography,Baoying People’s Hospital,Baoying 225800,Jiangsu Province,China)
出处
《肿瘤影像学》
2020年第6期565-569,共5页
Oncoradiology
关键词
肝脏局灶性病变
超声造影
诊断
Hepatic focal lesion
Contrast-enhanced ultrasound
Diagnosis
