脾血管淋巴管瘤的超声诊断

Ultrasound diagnosis of splenic hemangiolyphangioma

目的探讨脾血管淋巴管瘤超声声像图特征及超声诊断价值。方法对16例经手术病理证实的脾血管淋巴管瘤的二维声像图、彩色血流分布特征,以及5例患者的超声造影表现进行分析总结。结果 16例脾血管淋巴管瘤共25个病灶,常规超声检查示该病变表现为囊实性,呈"蜂窝"状,80.0%(20/25)的病灶边界清楚,80.0%(20/25)的病灶形态规则,72.0%(18/25)的病灶内部回声均匀,彩色多普勒血流成像示瘤内彩色血流信号显示率为56.0%(14/25)。超声造影示病灶均为整体树枝样增强,基本与脾实质同步增强,增强后回声始终比周围脾实质低,且持续增强时间较长。超声造影前后彩色多普勒血流检出率分别为62.5%(5/8)和100%(8/8)。结论以实性为主的脾血管淋巴管瘤在声像图上的均质高回声表现有一定特征性,超声检查有助于明确诊断。

Objective To investigate the diagnostic value of ultrasonography in spleen hemangiolyphangioma and the sonographic feature.Methods Sixteen patients with spleen hemangiolyphangioma were reviewed by routine ultrasound and color Doppler flow imaging(CDFI).The diagnosis of spleen hemangiolyphangioma was confirmed by pathology after operation.Contrast-enhanced ultrasonography(CEUS) was performed in five patients.Results There were 25 lesions totally.The lesions were cystic,honeycomb-shaped,well-demarcated(80.0%,20/25),clear margin(80.0%,20/25),and homogeneous(72.0%,18/25).CDFI showed blood flow in 56.0%(14/25) lesions.CEUS showed the lesions were mainly enhanced synchronously with the spleen parenchyma.The lesions were hypoechoic in comparison with the spleen parenchyma with branch-shaped diffuse enhancement pattern.The lesions also showed persistent enhancement.The detection rate of color flow before and after CEUS were 62.5%(5/8) and 100%(8/8),respectively.Conclusions Homogeneous hyperechoic leision with major solid portion is the characteristic sonographic feature of spleen hemangiolyphangioma.Ultrasound examination is helpful for the diagnosis of spleen hemangiolyphangioma.