超声造影诊断肝脏良、恶性病变的临床意义

Differential diagnosis of malignant and benign focal liver lesions by contrast enhanced ultrasound

目的了解超声造影诊断肝脏良、恶性病变的增强表现及临床意义。方法对经手术、病理、或增强CT(MRI)证实的58例患者60个肝局灶性病变进行超声造影,研究病灶的造影增强模式,并判断病变的良性、恶性。结果(1)恶性病灶:原发性肝细胞癌(HCC)9个呈"快进快出";转移性肝癌14个,动脉期多呈周边环状或厚圈状"快进",之后均廓褪为低或极低回声。(2)良性病灶:19个肝血管瘤多为典型"慢进慢出";9个局灶性增生结节多为快进慢出型,早期可见增强的中央血管及放射状血管,其余9个肝脏良性病灶多表现为"慢出"型。结论肝内良、恶性病灶具有不同的增强模式和特征,超声造影对肝内良恶性病变的鉴别诊断具有很好的应用意义。

Objective To investigate the imaging features and clinic significance of contrast enhanced ultrasound in malignant and benign focal liver lesions. Methods Sixty hepatic lesions in 58 cases underwent contrast enhanced ultrasound, and their imaging features were analyzed according to the findings of surgery, pathology, enhanced CT or MRI. Results Nine hepatocellular carcinomas showed swift enhancement in the arterial phase and swift expurgation in the portal phase, whereas 14 metastatic tumors revealed tim-like peripheral enhancement or perfusion defect. In 19 hemangiomas, 9 focal hyperplastic nodules, and 9 other benign tumors, the typical enhancement patterns were slow enhancement and expurgation, swift enhancement and slow expurgation, and slow expurgation, respectively. Conclusion There are different enhancement patterns in malignant and benign hepatic tumors. Contrast enhanced ultrasound is useful in the differential diagnosis of liver lesions.