肝脏局灶性结节性增生超声造影的典型特征和病灶大小的相关性研究

Typical signs of focal nodular hyperlasia using contrast-enhanced ultrasonogrphy:correlation with lesion size

目的:探讨肝脏局灶性结节性增生(FNH)超声造影的典型特征与病灶大小的联系。方法:本组采用新型超声对比剂SonoVue和对比脉冲序列成像技术,对33例FNH患者共35个病灶行超声造影检查(CEUS),观察病灶的增强模式和其它声像图特征,分析轮幅状的增强模式和中央疤痕的发生率;其中26例由CT、MRI证实,其余7例经手术或穿刺病理证实。结果:24个直径>3cm的病灶22个(22/24,91.7%)动脉相早期呈轮幅状增强,而11个直径<3cm的病灶4个(4/11,36.4%)为轮幅状增强,本组共计26个(26/35,74.3%)病灶呈轮幅状增强。本组22个(22/35,62.9%)病灶可见中央疤痕,其中19个(19/24,79.2%)直径>3cm的病灶和3个(3/11,27.3%)直径<3cm的病灶可见上述特征。结论:多数直径>3cm的FNH超声造影动脉相表现为典型的轮幅状增强模式,延迟相可见中央疤痕,如果无轮幅状增强和中央疤痕等声像图特征,则超声造影难以鉴别诊断FNH与其它富血供的肿瘤。

Objective：To investigate the relatiouship between typical signs of focal nodular hyperplasia（FNH）and lesion size using conwast-enhanced ultrasonogrphy（CEUS）. Methods：33 patients with thirty-five lesions were examined by new contrast agent SonoVue and contrast pulse sequence（CPS） ultrasound. The occourrence of spoke-wheel enhancement pattern and central hypoechogenic scar were evaluated. Twenty-six of them were diagnosed by CT or MRI, while the other 7 cases with pathological evidence through surgery or needle biopsy.Results：In 24 lesions larger than 3 cm, spoke-wheel pattern was observed in 22 lesions （22/24,91.7%）. In 11 lesions smaller than 3 cm, spoke-wheel pattern was found in 4 lesions （4/11,36.4%）. In total, spoke-wheel pattern was observed in 26 lesions （26/ 35,74.3%）. Generally, central scar was present in 22 lesions （22/35,62.9%）. In lesions larger than 3 cm, it was present in 19 lesions （19/24,79.2%）. In lesions smaller than 3 cm it was present in 3 lesions （3/11,27.3%）. Conclusion： Most of FNHs larger than 3 cm showed typical spoke-wheel enhancement pattern in arterial phase and central scar in delay phase on CEUS. If neither spoke-wheel phenomenon nor central scar are present, diagnosis of FNH can not be based on CEUS findings, other hypervascularized lensions should be included in differential diagnosis.