肝硬化再生结节的超声诊断

Ultrasonic diagnosis of liver cirrhosis with regenerating node

目的探讨肝硬化再生结节的超声特征,观察不同检查方法对病变的表现形式。方法对22例肝硬化再生结节患者进行二维灰阶超声、彩色多普勒超声检查后应用新型超声造影剂SonoVue对这些患者再行实时双模式灰阶成像超声造影检查。结果灰阶超声显示86.4%(19/22)的病灶位于肝右叶,54.5%(12/22)的病灶回声为低回声;36.4%(8/22)的病灶为等回声,9.1%(2/22)的病灶表现为高回声,86.4%(19/22)的病灶边界欠清,13.6%(3/22)的病灶边界清晰。彩色多普勒超声检查90.9%(20/22)的病灶内部及周边未见明显血流信号,9.1%(2/22)病灶内部可见散在点状血流信号,频谱为静脉频谱。超声造影95.5%(21/22)的病灶动脉相回声均无明显增强,门脉相与周围正常肝实质呈同步强化,延迟相回声与肝组织相似无明显分界而不易辩认。4.5%(1/22)的病灶动脉相增强为高回声,至延迟相与肝实质回声一致,无廓清现象。结论肝硬化再生结节在灰阶超声上表现多样,彩色多普勒多无明显血流信号,超声造影可以更显著地表现病灶特征,为诊断和鉴别诊断提供帮助。

[ Objective ] To investigate the manifestations of cirrhosis regenerated nodular on conventional grey scale and color doppler ultrasound examination, compare different diagnostic performance of different methods. [Methods] 22 patient underwent conventional grey scale and color doppler ultrasound examination, were checked by doulbe mode grey ultrasonography with a new contrast medium SonoVue. [Results] On conventional grey scale ultrasound, 19 （86.4%） lesions located in the right lobe of liver, 12 （54.5%） lesions were slightly hypoechoic, 8 （36.4%） lesions were isocchoic, 2 （9.1%） lesions were hyperechoic, 19 （86.4%） lesions were clouding border, 3 （13.6%） lesions were clear border. On color doppler ultrasound examination, 20 （90.9%） lesions internal and around were unconspicuous blood stream signs, spectrum were vein spectrum. On ultrasonography 21 （95.5%） lesions artery phase echo were commonly reinforcement. Hepatic portal vein and artery phase echo of hepatic parenchymal cell were synchronous reinforcement, delayed phase displayed as artery phase echo of hepatic parenchymal cell and were coulding border difficultly to recognize. 1 （4.5%） lesions artery phase echo increased as hyperechoic, delayed phase echo displayed as artery phase echo of hepatic parenchymal cell and were clouding border. [Conclusions] There are diversity manifestations of cirrhosis regenerated nodular diversity on conventional grey scale examination, and are unconspicuous stream sings on color doppler ultrasound examination. There are significant performances of lesions on ultrasonography, and the specificities could help for diagnosis and differential diagnosis.