超声造影在肝脏肿瘤和肝脏局部脂肪缺失鉴别诊断中的应用

Application of contrast enhanced ultrasound in the differential diagnosis of liver neoplasms from focal spared areas of fatty liver

目的:探讨超声造影对肝脏肿瘤和肝脏局部脂肪缺失鉴别诊断的价值。方法:64例脂肪肝伴肝内低回声灶患者,行超声造影检查,分析其造影表现与特征,并经手术或穿刺病理检查证实。结果:64例脂肪肝背景下肝脏肿瘤和肝脏局部脂肪缺失患者超声造影三期表现明显不同:18例肝细胞性肝癌中16例表现为"快进快退",2例表现为"快进慢退";16例转移性肝癌中10例表现为"快进快退",6例表现为"慢进快退";9例血管瘤表现为"慢进慢退";21例局部脂肪缺失表现为"等进等退"。结论:肝肿瘤有特征性造影表现,超声造影有助于肝肿瘤与肝脏局部脂肪缺失鉴别诊断。

Objective To explore the value of contrast enhanced ultrasound to the differential diagnosis of liver neoplasm from focal spared areas of fatty liver. Methods Sixty-four cases of fatty liver with hypo-echo nodules underwent contrast enhanced ultrasound examinations. Contrast enhanced ultrasound showing and features were analyzed in 64 cases. The results were confirmed by operation or needle pathological examination. Results Three staging demonstrations of contrast enhanced ultrasound were different in 64 cases of liver neoplasms from focal spared areas of fatty liver. In 18 cases of hepatocellular carcinoma,16 cases showed enhanced agent entering fast into disease tissues and passing out fast too,and 2 cases showed enhanced agent entering fast into disease tissues and exiting slowly. In 16 cases of metastatic liver cancer,10 cases showed enhanced agent entering fast into disease tissues and passing out fast too,and 6 cases showed enhanced agent entering slowly into disease tissues and exiting fast. Nine cases of hepatic hemangioma showed enhanced agent entering slowly into disease tissues and exiting slowly,too. Twenty-one cases of focal spared areas of fatty liver showed enhanced agent entering into nodules and exiting together with other tissues around. Conclusion Liver neoplasm has characteristic ultrasonographic features,which is helpful in the differential diagnosis of liver neoplasm from focal spared areas of fatty liver.