超声造影对脂肪肝背景下肝脏单个低回声局灶性病变的鉴别诊断

Evaluation of contrast-enhanced ultrasonography in differential diagnosis of single hypoechoic focal liver lesions within fatty liver

目的探讨实时超声造影对脂肪肝背景下肝脏单个低回声局灶性病变的诊断价值。方法应用常规超声和超声造影对106例脂肪肝患者肝脏单个低回声局灶性病变进行分析,并与病理诊断进行比较。结果 106例脂肪肝背景下肝脏低回声病灶中,超声造影诊断原发肝癌28例,转移性肝癌16例,肝血管瘤27例,肝脓肿9例,肝腺瘤1例,肝局灶性结增生5例,非均匀性脂肪肝11例。超声造影的诊断准确率为91.5%,明显优于常规超声的64.2%。结论超声造影可以提高脂肪肝背景下肝脏低回声局灶性病变的诊断准确率,是鉴别诊断脂肪肝背景下肝低回声结节的有效方法。

Objective To observe the value of contrast-enhanced ultrasonography（ CEUS） in differential diagnosis of single hypoechoic focal liver lesions（ FLLs） within fatty liver. Methods In 106 patients within fatty liver,the routine ultrasonography and CEUS features of 106 hypoechoic lesions were analyzed,and compared with pathological diagnosis derived from operation or ultrasound-guided biopsy. Results Among the 106 hypoechoic lesions within fatty liver,CEUS diagnosed 28 hepatocellular carcinomas（ HCCs）,16 metastases,27 emangiomas,9 liver abscesses,1 hepatic adenoma,5 focal nodular hyperplasias（ FNHs） and 11 non-uniform fatty liver. The diagnostic accuracy of CEUS was 91. 5%,which was significantly better than that of conventional ultrasonography with diagnostic accuracy of 64. 2%. Conclusion CEUS can improve the diagnostic accuracy in diagnosing hypoechoic FLLs within fatty liver,and it is effective in the differential diagnosis of FLLs within fatty liver.