肝脏炎性假瘤的多普勒超声和灰阶超声诊断

Diagnosis of inflammatory Pseudotumor of Liver by the Doppler and Ultrasonography

本文通过肝脏炎性假瘤（ＩＰＬ）的Ｂ超、彩色多普勒（ＣＤ）和脉冲多普勒（ＰＤ）的表现，探讨它们对ＩＰＬ的诊断价值。本组病例共１０例，１２个病灶，最大４ｃｍ，最小０．８ｃｍ．检查时先用Ｂ超显示，后用ＣＤ检测血流，如有血流，则用ＰＤ检测流速及阻力指数（ＲＩ）。结果显示ＩＰＬ在Ｂ超上均表现为低回声欠均质光团，个别有晕圈样表现，Ｂ超容易误诊，本组符合率仅为２５％。进一步分析发现ＩＰＬ在Ｂ超上可有形态不规则多呈哑铃状或葫芦状表现，实时下可有延伸感，并且后方无增强改变，这些对诊断ＩＰＬ有帮助。在９个经ＣＤ和ＰＤ检查的ＩＰＬ中，６个未见彩色血流；３个周边有彩色血流并且测及动脉频谱，其中２个ＲＩ＜０．５。这些表现均与病理显示相吻合。而多普勒诊断ＩＰＬ为良性病变的符合率为８９％（８／９），与Ｂ超结合诊断为ＩＰＬ的符合率为５６％（５／９），显著高于单纯Ｂ超检查。因此，多普勒结合Ｂ超对ＩＰＬ的诊断有很大帮助。

Ten patients with 12 inflammatory pseudotumor of the liver (IPL) lesions were routinely examined by gray scale ultrasonography (B- US), color Doppler (CD) and pulsed dappler (PD). All of them in B-US were hypoechoic pattern with inhomogeneity, and one o.f them displayed helo-like margin, suggesting malignant tumor. However, the. irregular shape with calabash-like was found in ic IPL lesions by B-US, being different from liver cancer. The color blood now and arterial.spectrum were detected by CD and PD in the margin 3 of 9 IPL lesions, and the resistant index was less than 0. 5 in 2 of 3 IPL with Doppler signals, 6 of.them were suggested to lack of blood supply, the manifistations of Doppler were consistment with pathology of IPL. Therefore, 8 lesions were considered to be benign lesions by Doppler US and the accuracy for the diagnosis of IPL was 56K (5/9) by using Doppler combined with B-US.