肝内胆管细胞癌超声造影增强模式探讨

The analysis of dynamic enhancement pattern of intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound

目的分析肝内胆管细胞癌（ICC）的超声造影增强模式，探讨其诊断价值。方法38例ICC患者，共38个病灶，注射超声造影剂SonoVue后分析病灶增强水平与增强方式。结果ICC病灶直径1．7-9．6cm，平均（5．6±2．2）cm。动脉相增强模式：均匀高增强5个，不均匀高增强10个，均匀低增强1个，不均匀低增强13个，环状增强6个，部分增强2个，均匀等增强1个。门脉相：低增强36个，等增强2个。延迟相：38个均表现低增强。14个病灶在注射造影剂45s内开始消退，22个在45～120S消退，2个在120S后消退。结论ICC超声造影表现为动脉相多种增强模式，与病灶大小有一定相关性。

Objective To evaluate the value of contrast-enhanced ultrasound （CEUS） in the diagnosis of intrahepatic cholangiocarcinomas （ICC） and analyze their dynamic enhancement patterns. Methods The enhancement levels and patterns of 38 lesions in 38 patients with ICC who had undergone preoperative CEUS were retrospectively analyzed. Results The diameter of ICC lesions were 1.7-9.6 cm,the average diameter was （5.6_＋2.2）cm. Seven patterns were shown during the arterial phase including 5 lesions of homogeneous hyperenhancement, 10 lesions of heterogeneous hyperenhancement, 1 lesion of homogeneous hypoenhancement, 13 lesions of heterogeneous hypoenhancement, 6 lesions of peripheral rim-like enhancement, 2 lesions of partially enhancement and 1 lesion of homogeneous isoenhancement. During the portal phase, 36 lesions were hypoenhanced and 2 lesions were isoenhanced. During the late phase, hypoenhancement was observed in all lesions. It appeared washout during 45 s in 14 lesions,between 45-120 s in 22 lesions and after 120 s in 2 lesions. Conclusion ICC may display a variety of patterns in the arterial phase and hypoenhaneement in the portal phase using CEUS. The enhancement patterns of ICC are correlated with tumor sizes.