超声造影在脾脏外伤鉴别诊断中的价值

Application value of contrast-enhanced ultrasound in differential diagnosis of spleen trauma

目的探讨超声造影在外伤患者脾脏不典型病灶中的诊断价值。方法 43例常规超声发现脾脏内病灶,但难以定性的外伤患者进行超声造影检查,观察不同病灶造影增强过程的特点。结果 43例脾内不典型病灶,常规超声表现:病灶呈低回声25例,高回声5例,无回声6例,混合回声7例;病灶边界清晰14例,边界欠清或不清29例。超声造影表现:血肿27例,血管瘤6例,分叶脾2例,脾先天性切迹3例,动脉瘤5例。脾脏病灶常规超声正确诊断35例,超声造影正确诊断42例,误诊1例不完全灌注的血管瘤为血肿。结论超声造影对脾脏外伤不典型病灶有较高的诊断价值。

Objective To explore the application value of contrast - enhanced ultrasound （ CEUS ） in diagnosis of traumatic patients with atypical lesions in spleen. Methods Forty - three patients were found with lesions in spleen by uhrasonography, then CEUS was performed on traumatic patients who were difficult to identify, the changes of dynamic contrast - enhanced process in early and late stage were observed, and the characteristics of CEUS were analyzed. Results In 43 cases of atypical lesions in spleen, the conventional ultrasonic appearances were as follow：there were 25 cases of low level echo,5 cases of high level echo,6 cases of eeholess ,7 cases of mixture echo, and there were 14 cases with clear edge, 29 cases with unclear edge. While the CEUS appearances were as follow：there were 27 cases of hematoma,6 cases of hemangioma,2 cases of leaflet spleen,3 cases of congenital notch spleen,5 cases of aneurysm. There were 35 cases of spleen lesions diagnosed correctly by conventional ultrasound ,42 cases diagnosed correctly by CEUS ,and 1 case of non total perfusion hemangioma was misdiagnosed as hematoma. Conclusion CEUS has important value in diagnosis of atypical lesions in patients with spleen trauma.