超声造影在泡型肝包虫病与肝血管瘤鉴别诊断中的价值

The value of contrast-enhanced ultrasonography in the differential diagnosis of hepatic hydatidosis and hemangioma

目的探讨超声造影对泡型肝包虫病(HAE)与肝血管瘤(HHE)的鉴别诊断价值。方法纳入2010年1月~2019年4月我院收治的HAE及HHE患者共102例,其中HHE患者57例,HAE患者45例。患者均行超声造影检查,分析、比较HHE及HAE的超声造影特征,包括病灶的位置、数目、大小、内部回声、边界、形态、血流、造影时增强模式等。结果两组患者年龄差异及性别构成差异无统计学意义(P>0.05)。57例HHE患者共有61个病灶,病变平均大小为(6.5±3.9)cm。45例HAE患者共有57个病灶,病变平均大小为(8.7±4.9)cm,两组病灶大小的差异有统计学意义(P<0.05),两组病灶内部回声构成、病灶血流差异均无统计学意义(P>0.05);两组病灶的位置、边界、形态差异有统计学意义(P<0.05)。超声造影对泡型肝包虫病和肝血管瘤的检出率高于常规超声,且差异有统计学意义(P<0.05)。两组患者在动脉期周边增强及病灶内部增强间的差异均有统计学意义(P<0.05)。结论HAE及HHE的常规超声表现有部分相似,但超声造影表现有明显差异。常规超声结合超声造影可以帮助对HAE与HHE的鉴别。

Objective To determine the value of contrast-enhanced ultrasound(CEUS)in the differentiation of hepatic hemangioma(HHE)and hepatic alveolar echinococcosis(HAE).Methods The data of 102 patients with HHE or HAE were collected between January 2010 and April 2019.Grayscale and CEUS features of the patients were analyzed.The frequency of each imaging finding,including location,number,size,internal echo,boundary,morphology,blood flow,arterial enhancement,and internal enhancement were evaluated and compared.Results There was no significant difference in age and gender composition between the two groups(P>0.05).61 HHE lesions were detected in 57 patients.The diameters of HHE lesions were 0.7-20cm with an average of(6.5±3.9)cm.57 HAE lesions were found in 45 patients.The diameters of HAE lesions were 1.3-20 cm with an average of(8.7±4.9)cm.The difference in lesion size between the two groups was statistically significant(P<0.05).There were no statistically significant differences in lesion internal echo composition,and the blood flow between the two groups(P>0.05).There were statistically significant differences in lesion location,boundary and morphology between the two groups(P<0.05).Contrast-enhanced ultrasonography had a higher detection rate than conventional ultrasonography for hepatic echinococcosis and hepatic hemangioma,and the difference was statistically significant(P<0.05).The presence of arterial enhancement and absence of internal enhancement were significantly different between HHE and HAE(P<0.05).Conclusion The ultrasonographic findings of HHE and HAE were partly similar,but there were significant differences in contrast-enhanced ultrasonography.HAE and HHE detection rates have been improved with CEUS,and they can be distinguished with Grayscale and CEUS.