实时超声造影在肝脏占位性病变鉴别诊断中的应用

目的探讨超声造影对肝脏占位性病变鉴别诊断的应用价值。方法对57例经彩色多普勒超声诊断为肝脏占位性病变的患者进行肝脏超声造影,实时动态记录超声造影过程,观察病灶区造影剂的灌注过程及造影前后声像图特点。结果 57例肝占位患者中,多囊肝1例,肝血管瘤21例,肝癌20例,肝癌合并肝血管瘤2例,局灶性增生3例,肝血管瘤合并局灶性增生1例,不均匀性肝脂肪浸润8例,肝包虫病1例。其中多囊肝,肝包虫病未见造影剂充填,其余病例均出现不同程度的强化过程。肝癌表现为典型的"快进快出";血管瘤表现为向心性环状增强;局灶性增生呈离心性轮辐状增强;不均匀性肝脂肪浸润则未见造影剂聚集,与肝实质呈均匀强化。结论实时超声造影能提高肝内占位性病变诊断的准确性,具有重要的临床应用价值。

Application of real-time ultrasonography in diagnosis of focal liver lesions

Objective To investigate the value of real-time contrast-enhanced ultrasonography(CEUS) in the diagnosis of focal liver lesions.Methods CEUS and color Doppler ultrasound were applied to 57 patients with hepatic lesions.Ultrasound contrast real-time dynamic record was performed in the entire process,and the lesions and the features of contrast agent perfusion imaging before and after the process of sonography were observed.Results Fifty-seven patients with liver lesions were diagnosed,including 1 polycystic liver,21 hepatic hemangioma,20 liver tumor,3 focal hyperplasia of the liver,8 uneven fatty infiltration of liver,and 1 hepatic hydatid disease,of which polycystic liver and liver echinococcosis showed no contrast agent filling,and the remaining cases had different degrees of enhancement process.Liver tumor showed the typical "fast wash-in and fast wash-out’’.Hemangioma showed ring enhancement.Focal hyperplasia displayed centrifugal spoke-like enhancement.Uneven fatty infiltration of the liver showed no contrast accumulation with the liver parenchyma showing homogeneous enhancement.Conclusion Real-time CEUS can improve the diagnostic accuracy in liver lesions and provide more information on clinical treatment.