肝海绵状小血管瘤超声与螺旋CT诊断价值分析

The value of helical CT and ultrasound in the diagnosis of small cavernous hemangioma of liver

目的探讨肝海绵状小血管瘤在超声及CT的影像学特点,分析其病理与影像学的关系,比较不同检查方法对病灶的敏感性及特异性。方法回顾性分析经超声(US)与螺旋CT三期扫描的32例共38个病灶的资料,记录病灶在各个时相的增强形态特点,结合文献病理改变分析病灶在US与螺旋CT三期扫描的影像学表现。结果超声发现病灶38例,其中31例(81.6%)病灶呈高回声,5例(13.2%)病灶呈低回声,2例(5.2%)为混合回声。32例CT扫描,单发病灶28例,多发病灶4例,共38个病灶。平扫多表现为圆形或类圆形低密度影;动态增强(动脉期、门静脉期、延迟期)随病理不同,全瘤强化快、慢各有明显不同。结论超声可做为肝海绵状血管瘤(CHL)的首选方法,采用螺旋CT在定性方面上加以证实,不同方法之间的联合运用,可提高对肝海绵状小血管瘤的诊断水平。

Objective To investigate the helical CT and ultrasound appearances（US） for small cavernous hemangioma of liver,analyze the relation between pathologic features and imaging characteristics.Compare sensitivity and specificity in lesion detection by different methods.Methods Retrospective analysis combined with literature analysis were given in pathologic features and imaging appearances of 38 lesions in 32 cases by US and three phases helical CT scans.Results 38 lesions had been detected by US.31 cases（about 81.6%） show hyperechoic,5 cases（about 13.2%） appeared hypoechic,and 2 cases（about 5.2%） showed mixed echoes.38 lesions including 28 cases of single lesion and 4 cases of multi-lesions had been detected by 32 CT scans.The lesions showed round or quasi-circular shape with low densities in plain CT scans.The lesions appeared various enhancements according to the pathologic differences in dynamic enhanced CT scans with arterial phase,portal phase and delay phase.Conclusions US can be the first choice to detect canrvernous hemangioma.Qualitative diagnosis can be made by helical CT scan.The diagnosis ability of cavernous hemangioma of liver can be improved by using combined methods.