肝血管瘤合并脂肪肝超声造影诊断价值

Value of Contrast-enhanced Ultrasonography in Diagnosis of Hepatic Hemangioma in Fatty Liver

目的探讨肝血管瘤在脂肪肝背景下的超声造影诊断价值。方法 30例肝血管瘤患者进行彩色多普勒超声检查及双幅对比超声造影检查。根据是否合并脂肪肝分为Ⅰ组(合并脂肪肝)与Ⅱ组(未合并脂肪肝且无其它肝脏疾病);再根据超声造影表现分为A组(动脉期病灶不全充填)与B组(动脉期病灶整体均匀快速增强),将Ⅰ、Ⅱ组及A、B组交叉归类进行分析。结果肝血管瘤彩色多普勒超声检查诊断符合率53.8%～64.7%。超声造影检查:A组(ⅠA组及ⅡA组)超声造影诊断符合率100%(8/8);B组中,ⅠB组造影剂消退慢于周围肝实质10例,快于周边肝实质2例,同速于周边肝实质1例,超声造影诊断符合率76.9%(10/13),ⅡB组造影剂消退均慢于周围肝实质,超声造影诊断符合率100%(9/9)。结论超声造影对肝血管瘤诊断符合率高,超声造影显著提高了在脂肪肝背景下对肝血管瘤诊断符合率。但在脂肪肝背景下,病灶呈整体均匀快速增强时,则需进一步检查明确性质。

Objective To probe the value of contrast-enhanced uhrasonography in the diagnosis of hepatic hemangioma in fatty liver. Methods In 30 cases of hepatic hemangioma, conventional 2D and color Doppler ultrasound were conducted firstly, and then double mode contrast ultrasound were carried out. The 30 cases were divided into group I （ combined with fatty liver） and group II （without fatty liver or other liver diseases） ;And then were assigned to group A（ 8 cases, insufficiently filled with contrast agent in artery phrase） and group B （22 cases, uniformly rapidly increased with contrast agent in artery phrase）. The statistical analysis was processed among these groups. Results The diagnostic accurate rates of hepatic hemangioma carried out by 2D and color Doppler ultrasound were 53.8% to 64.7%. The diagnostic accurate rate of contrast-enhanced uhrasonography in group A （ both group I A and group 1[ A） was 100% （8/8） ;In group I B,the agent-subsided velocity was slower as compared to the liver parenchyma around in 10 cases, faster in 2 cases and equal in 1 case, the diagnostic accurate rate of contrast-enhanced uhra- sonography in group [ B was 75.9% （10/13）. In group 1I B, the agent-subsided velocity was slower than normal liver around in all cases, and the diagnostic accurate rate of contrast-enhanced ultrasonography in group IIB was 100% （9/9）. Conclusion The contrast-enhanced uhrasonography has a high diagnostic accurate rate for hepatic hemangioma in fatty liver. The further examinations are needed when the hemangioma was uniformly rapidly increased with contrast agent.