手术证实的肝脏局灶性结节增生超声造影特征与大小的关系

目的 研究肝脏局灶性结节增生(focal nodular hyperplasia,FNH)超声造影(contrast enhanced ultrasound,CEUS)的典型征象,及其与病灶大小及脂肪肝背景的关系.方法 回顾性分析2017年10月—2019年12月复旦大学附属中山医院经手术切除病理证实的51例FNH患者...

Contrast-enhanced ultrasound features of surgically confirmed liver focal nodular hyperplasia in correlation with lesion size

Objective To assess the typical contrast enhanced ultrasound (CEUS) enhancement characters of hepatic focal nodular hyperplasia (FNH),and to analyze the correlation with lesion size and fatty liver background. Methods We retrospectively assessed CEUS characteristics in 51 cases of FNH pathologically confirmed after surgical resection during Oct 2017 to Dec 2019,and analyzed the differences in 3 groups with different lesion sizes (<3 cm,3-5 cm,>5 cm) and 2 groups with different liver background (fatty liver,normal liver). Results All FNH lesions displayed a rapid hyper-enhancement in arterial phase of CEUS.During the arterial phase,41.2% (21/51) lesions showed gushing-spring enhancement;29.4% (15/51) showed spoke-like enhancement; 21.6% (11/51) showed dendritic enhancement;7.8% (4/51) showed whole enhancement. The detection rate of central scar was 31.4% (16/51).The appearance rate of feeding arteries was 74.5% (38/51). According to echogenicity shift of the lesions in various phases,96.1% (49/51) FNH showed "fast-in and slow-out" or "fast-in and synchronous-out", and only 3.9% (2/51) showed "fast-in and fast-out".In the above performances,the detection rate of gushing-spring enhancement increased to 71.4% (15/21) in lesions <3 cm,that of dendritic enhancement increased to 50% (5/10) in lesions >5 cm, and that of central scar increased to 60% (6/10) in lesions >5 cm.Significant difference was found in those performance in different size groups (Fisher's exact test, P<0.05). In addition,performance on CEUS showed no significant difference in different liver background groups (Fisher's exact test or χ² test). Conclusion The characteristic signs of FNH at CEUS include gushing-spring sign,spoke-wheel sign,central scar and feeding artery. Gushing-spring sign is more valuable for diagnosing small size FNH (<3 cm),while central scar is useful for diagnosing larger FNH lesion (>5 cm).