肝脏上皮样血管平滑肌脂肪瘤的实时超声造影表现特征

Imaging features of hepatic epithelioid angiomyolipomas on real-time contrast-enhanced ultrasound

目的探讨肝脏上皮样血管平滑肌脂肪瘤（EAML）的超声造影表现特征。方法回顾性分析17例经手术病理证实为肝EAML患者的常规超声和超声造影声像图，分析其表现特征。结果所有病例均为单发病灶。70．6％（12／17）病灶常规超声呈低回声，82．4％（14／17）病灶内部回声不均匀。彩色多普勒血流成像（CDFI）显示88．2％（15／17）病灶内有彩色血流信号，82．4％（14／17）病灶周边可见环状或弧形包绕的供血动脉，RI值为0．38～0．56。超声造影动脉期全部病灶显著高增强，29．4％（5／17）病灶呈树枝样增强，70．6％（12／17）病灶呈整体弥漫增强。29．4％（5／17）病灶可见周边显著环状高增强区。88．2％（15／17）病灶在增强峰值期呈整体均匀填充。门脉期和延迟期各有41．2％（7／17）和64．7％（111／17）病灶减退呈低增强。结论超声造影结合常规超声和CDFI表现特征，有助于诊断肝EAML。

Objective To evaluate the imaging features of hepatic epithelioid angiomyolipoma （EAML） on contrast-enhanced ultrasound （CEUS）. Methods The imaging features of pathologically proved hepatic EAML lesions in 17 patients who had undergone baseline ultrasound and CEUS examinations were evaluated retrospectively. Results All of the cases were single lesion. 70.6% （12/17） of the lesions were hypoeehoic on ultrasound and 82.4% （14/17） of the lesions were heterogeneous. Flow signals were detected in 88.2 %（15/17） of the lesions and 82,4% （14/17） of the lesions showed ringlike or arc arterials peripherally on color Doppler flow imaging （CDFI）. The value of RI was 0.38 - 0.56. On CEUS, all lesions exhibited remarkable hyperenhancement in the arterial phase. 29.4%（5/17） of the lesions showed branched enhancement, 70. 6% （12/17） of the lesions showed diffusely entire enhancement. Strong ring-like enhancement peripherally was detected in 29.4% （5/17） of the lesions. 88.2% （15/17） of the lesions were detected homogeneously enhancement during the peak period on CEUS. Washout of contrast agent and hypoechogenicity to surrounding liver tissue during portal or late phase were observed in 41.2% （7/17） and 64.7 % （11/17） of the cases retrospectively. Conclusions The combination of real-time CEUS and baseline US can improve the correct diagnosis of hepatic EAML.