超声造影对肝脏局灶性病变误诊分析

目的 探讨肝脏局灶性病变的CEUS误诊原因.方法 回顾性分析与病理结果不符的40例肝脏病变的CEUS特征,分析其误诊原因.结果 40例CEUS误诊病例中,14例病理诊断为肝细胞性肝癌(HCC),其中4例误诊为局灶性结节增生,3例误诊为血管瘤,4例误诊为肝硬化结节,1例误诊为肝脓肿,2例误诊为良性病变,其中1例肝转移性腺癌,误诊为炎性病灶;1例胆管细胞癌误诊为良性病变.24例病理诊断为良性病灶,其中21例CEUS误诊为恶性肿瘤,3例误诊为其他良性病变.结论 加深对肝脏病变病理、组织形态特点的理解,仔细观察CEUS图像特征,紧密结合临床,可提高CEUS对肝脏病变的诊断正确率.

Misdiagnosis analysis of contrast ultrasonography in local liver lesions

Objective To analyze the misdiagnosis reasons of CEUS in focal lesions. Methods The images of 40 cases misdiagnosed with CEUS were reviewed, and the misdiagnosing reasons were analyzed. Results In 40 cases, 14 lesions were proved by pathology as hepatocellular carcinoma, but 4 cases were misdiagnosed as local nodular hyperplasia, 3 cases were misdiagnosed as hemangioma, 4 cases were misdiagnosed as liver cirrhosis nodules, 1 case was misdiagnosed as liver abscess, and 1 adenocarcinoma metastases case was misdiagnosed as a liver inflammatory lesion, 1 cholangiocellular carcinoma case was misdiagnosed as a benign lesion. The other 24 cases were pathologically proved to be benign, but 21 cases were misdiagnosed as malignant lesions and 3 cases were misdiagnosed as other benign ones. Conclusion Recognizing the liver pathology and tissue morphologys, analyzing the image features of CEUS carefully, combining clinic finings may improve the diagnostic accuracy of CEUS.