肝脏罕见、疑难病例超声造影表现

CEUS characteristics of rare and difficult liver lesions

目的探讨肝脏罕见、疑难病变的CEUS表现。方法回顾性分析6例经手术后病理证实的肝脏罕见、疑难病变的CEUS增强特点。结果 2例肝脏未分化肉瘤,动脉期实性成分呈高增强,门静脉及延迟期呈低增强;1例肝内胆管囊腺瘤,动脉期囊壁呈高增强,门静脉期及延迟期呈等增强;1例肝内胆管囊状扩张症和1例慢性肝脓肿,囊壁及分隔处三期均呈等增强;1例肝脏炎性肌纤维母细胞瘤动脉期呈稍高增强,门静脉期呈等增强,延迟期呈低增强。结论肝脏未分化肉瘤及炎性肌纤维母细胞瘤的CEUS增强模式与肝脏恶性肿瘤相似;通过CEUS观察动脉期病灶囊壁及分隔处是否高增强,有助于鉴别肝内胆管囊腺瘤和其他二维图像相似的肝脏分房囊性病变。

Objective To investigate CEUS characteristics of rare and difficult liver lesions. Methods Six patients with rare and difficult liver lesions confirmed by surgery and pathology were enrolled, and their two-dimensional, color Doppler imaging and CEUS characteristics were retrospectively analyzed. Results Solid component masses of undifferentiated sar- coma of the liver of 2 patients were hyper-enhanced in arterial phase, while low-enhance was observed in portal and delay phase. The wall of intrahepatic biliary cystadenoma in 1 patient was hyper-enhanced in arterial phase, while homo-enhance was observed in portal and delay phase. In 1 patient of intrahepatic cystic dilatation of bile duct disease and 1 patient of liver chronic abscess, the walls and septums homo-enhanced in all three phases. Liver inflammatory myofibroblastic in 1 patient showed hyper-enhancement in arterial phase, homo-enhancement in portal phase, and hypo-enhaneement in delay phase. Conclusion The CEUS enhancement patterns of undifferentiated sarcoma of the liver and liver inflammatory myofibroblas- tic showed similar to that of malignant liver tumors. The walls and septums showed hyper-enhanced in arterial phase, is helpful to distinguish the intrahepatic biliary cystadenoma from the liver cystic lesions with similary two-dimensional images.