脂肪肝内低回声局灶性病变的声诺维实时造影增强超声定性诊断

Real-time imaging with the sonographic contrast agent SonoVue:differentcation of benign and malignaut hypoechoic focal lesions in fatty liver

目的:应用声诺维实时增强超声造影技术对脂肪肝内低回声局灶性病变进行良恶性鉴别诊断。方法:对用常规超声发现的33例脂肪肝患者的41个肝内低回声局灶性病变进行了超声造影检查,通过增强螺旋CT、M R、组织病理诊断及临床表现来明确病灶性质。结果:共有7个恶性病灶,包括2个肝细胞肝癌,3个转移癌,1个胆管细胞癌和1个何杰金氏淋巴瘤;良性病灶34个,包括11个血管瘤,5个局灶性结节增生(FNH),18个非均匀性脂肪肝。通过超声造影,34个良性病灶中的33个及7个恶性病灶全部被正确定性诊断。结论:声诺维实时超声造影增强技术能对脂肪肝内局灶性低回声病变进行良恶性鉴别诊断。

Objective:We use real-time contrast-enhanced ultrasound(CEUS)technique with the sonographic contrast agent SonoVue to diagnosis between benign and malignant hypoechoic focal lesions in fatty liver.Methods:We studied 41 hypoechoic liver lesions(in 33 patients) found on conventional grayscale sonography with contrat-enhanced ultrasonography.Final diagnosis was made using contrast enhanced helical CT,contrast enhanced MR,and histopathic confirmation or clinical imaging follow-up.Results:There were 7 malignant lesions demonstrated:2 hepatocellular carcinomas,3 metastatic carcinomas,1 cholangiocellular carcinomas and 1 non-hodgkin′s 1ymphoma.34 benign lesions demonstrated:11 hemangiomas,5 focal nodular hyperplasias(FNH),18 focal areas of sparing in hepatic steatosis.CEUS characterized 33/34 benign lesions and 7/7 malignant lesions.Conclusion:CEUS with SonoVue contrast agent can distinguish malignant from benign hypoechoic lesions in fatty liver.