肝泡状棘球蚴病的超声图像分析

本文分析了经病理证实的１５例肝泡状棘球蚴病的声像图表现，其中巨块型８例，占５３．３％，结节型１例，占６．７％，坏死液化型３例，占２０％，混合型３例，占２０％。其声像图特征为：肝脏肿大，肿块与周围组织分界不清或外形不规整，凹凸不平呈“花菜”状，内部显示为不均匀结节状，小囊状高回声，有时见较小的钙化灶回声；病灶坏死腔可呈“溶洞”样透声区，腔壁回声增强。在进行诊断时应同肝囊型包虫病钙化、实性变、肝血管瘤、肝癌仔细鉴别。     

肝结核8例报告

目的：探讨肝结核诊治经验。方法：1998年5月～2003年11月泉州市第一医院收治8例肝结核患者，回顾临床表现及诊治情况。结果：2例术前确诊为肝结核行内科治疗；6例疑是原发性肝癌，剖腹探查，术中病理示肝结核。8例均痊愈。结论：肝结核缺乏特异性表现。对疑似原发性肝癌的Ⅱ型患者，术中病理确诊后行相应肝叶切除，结合术后抗结核治疗，均能获得治愈。     

肝局灶性结节增生的CT及MRI特征

目的 探讨肝局灶性结节增生的影像学特点.方法 回顾性分析12例经病理证实的肝局灶性结节增生症患者的CT 及MRI影像学特征,其中行CT检查者5例,行MRI检查者7例.结果 12例中单发者11例,多发者1例.5例行CT检查者,平扫呈等密度者4例,呈低密度者1例.7例行MRI检查者,平扫呈长T1、长T2信号者共3例,呈等T1、等T2信号者共4例.7例中5例病灶中央可见星状长T1、长T2信号影.增强扫描动脉期,12例患者病灶周边实质均呈显著强化,门静脉期及延迟期病灶周边实质强化减弱,中央星状疤痕呈延迟性强化.结论 肝局灶性结节增生的CT及MRI表现具有一定特征性,对该病的诊断及鉴别诊断具有重要价值.     

肝动脉动态声学造影对肝内实质性占位病变诊断的研究

本文报道了采用泛影葡胺对３０例肝脏肿瘤进行肝动脉动态声学造影的声像图结果。根据病变区与周围组织的回声变化，声像图结果可分为三型，Ａ型：病变区快进快出的增强呈“满天星征”，在２２例原发性肝癌中有１９例显示此征，占８６％；Ｂ型：病灶区边缘结节状强化，并向中心扩散，在５例肝海绵状血管瘤中见于４例；Ｃ型：病灶周边回声增强，见于肝转移癌３例及巨块型肝癌１例。此外我们还分析了声像图结果与病理的联系，并指出这种超声造影的方法弥补了Ｘ线血管造影与彩色多普勒血流显像（ＣＤＦＩ）中的一些不足之处。     

彩色多普勒超声对肝硬化患者眼血流动力学研究

目的应用彩色多普勒超声观察肝硬化患者眼动脉和视网膜中央动脉的血流动力学改变。方法检测35例正常对照组3、0例早期肝硬化患者和31例晚期肝硬化患者眼动脉(OA)和视网膜中央动脉(CRA)的收缩期峰值流速(Vs)、舒张末期流速(Vd)和阻力指数(RI)。结果与正常对照组比较,早期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.05),RI降低(P0.05);晚期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.01),RI升高(P0.05)。结论肝硬化患者眼血管血流动力学改变符合全身高动力循环状态,但随病程进展有不同的表现。     

Contrast‐Enhanced Breast Ultrasonography

Objective. The purpose of this study was to identify histopathologic correlates for the varied appearances of breast masses on contrast‐enhanced ultrasonography (CEUS). Methods. Contrast‐enhanced ultrasonography was performed in 104 patients (age range, 19–86 years) after administration of a sulfur hexafluoride microbubble contrast agent, and enhancement patterns were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, and heterogeneous enhancement. All patients' histologic slides were reviewed and correlated with CEUS findings. Results. In malignant masses, heterogeneous enhancement corresponded to tumor cell cords or clusters in a variable amount of desmoplastic stroma. Homogeneous enhancement corresponded to hypercellularity in the whole mass, or ductal carcinoma in situ (DCIS) was predominant. Regional enhancement corresponded to a DCIS component. Peripheral enhancement corresponded to a DCIS component, hypercellularity or adenosis at the periphery, and low‐degree cellularity, degeneration, fibrosis, or necrosis in the center. No enhancement was present in 1 case of low‐grade DCIS. In benign masses, heterogeneous enhancement corresponded to loose cell proliferation in a more sclerotic stroma. Homogeneous enhancement corresponded to diffuse hypercellularity, an inflammatory cell infiltrate, or intraductal papilloma. Regional enhancement corresponded to focal hypercellularity or intraductal papilloma within a dilated duct. No enhancement corresponded to desmoplastic stroma. Peripheral enhancement was shown in 1 case of granulomatous mastitis with an inflammatory infiltrate at the periphery and necrosis in the center. Conclusions. Breast mass CEUS findings correlated with histologic features.     

肝脏VX2肿瘤声学造影-剂量与效应关系

目的： 探讨不同声学造影剂剂量在肝脏 ＶＸ２ 肿瘤显影中的增强效果及变化规律。方法： １３ 只患有ＶＸ２ 肝肿瘤的新西兰白兔分别经外周静脉注射氟碳声学造影剂０．０１、０．０２、０．０４ｍ ｌ／ｋｇ, 按常规连续显像和延迟显像方式然后用高频基波显像和二次谐波显像观察肿瘤造影效果。结果： 基波显像在０．０１、０．０２、０．０４ 剂量水平产生的视觉肿瘤显影评分显著低于二次谐波显像 （Ｐ＜ ０．０１）, 基波显像在０．０１、０．０２、０．０４ 剂量水平产生的肿瘤显影视频密度值分别为２３．２３±７．５４、４０．０２±１０．１８ 和４３．７８±１０．４, 二次谐波显像的对应值是６５．５５±１１．３３、８７．８３±１７．０３和１１２．１６±２３．３８ （Ｐ＜ ０．０１）。结论： 声学造影剂量－效应关系在二次谐波显像中变化敏感, 在基波显像中变化相对不敏感。     

肝脏增生结节的声像图类型与随访价值

报道１２例经临床及手术病理证实的肝脏结节性增生病灶的超声表现类型与随访结果。手术９例中５例病理报告不典型增生伴局灶性癌变、间变及异型增生。不典型增生是癌前病变，在本文随访中也证实此种观点。影像学检查无论ＣＴ、血管造影还是超声显像都存在困难，定期超声检查观察结节增长速度和形态，配合ＡＦＰ动态观察及增殖细胞核抗原标记指数增高，对预示癌变有较大帮助。必要时穿刺细胞学检查很有价值     

Ultrasonic Assisted Permanent Pacing in a Patient with Severe Pulmonary Tuberculosis

A 67-year-old male patient with previous history of pulmonary tuberculosis presented with syncope due to complete heart block. Collapse of the right lung and deviation of the heart to the right chest had prevented visualization of the cardiac silhouette by fluoroscopy. Successful endocardial permanent pacing using a passive fixation electrode was achieved with the help of ultrasonic visualization of the cardiac chambers.     

原发性肝癌在高危人群中检出率的多普勒超声研究

报道１０３８３例肝脏Ｂ超和脉冲多普勒（ＰＷ）血流参数检查结果，旨在探讨原发性肝癌（ＰＨＣ）在高危人群中的检出率及其声像图、血流动力学特点。结果表明：正常肝脏组ＰＨＣ检出率为０．１４％，脂肪肝组检出率为０．８４％，与正常肝组比较差异显著（ＲＲ＝６，９５％ＣＩ＝３．２２～１８．３６）；慢性肝病及ＨＢＶ感染组ＰＨＣ检出率为１０．５６％，显著高于正常肝组（ＲＲ＝７５．４３，９５％ＣＩ＝４０．２１～１３７．５３）；肝硬化组ＰＨＣ检出率为３６．６１％，与正常肝组比较有极显著差异（ＲＲ＝２６１．５，９５％ＣＩ＝１４０．４５～４７９．１４）。     

胃三维容积超声造影与上消化道碘水造影在G-POEM手术疗效评估中的价值分析

目的 探讨胃三维容积超声造影与上消化道碘水造影在G-POEM手术疗效评估中的价值,从而为临床选择更合适的影像学检查方法。 方法 经东南大学附属中大医院消化科医生确诊胃轻瘫且需要进行G-POEM手术的患者共93例,根据胃排空检查方法的不同分为A组（超声胃三维容积检查）和B组（X线碘水造影检查）,其中A组48例、B组共46例,A组口服超声造影剂后在5min、15min、30min、60min及90min时间点时进行超声测量,B组在口服碘水造影剂后在上述相同时间点进行上腹部平片,上述方法在G-POEM手术前、后各测量一次,分别得到三维超声造影方法及碘水造影方法估测的G-POEM手术前、后的胃容积,从而各自评估G-POEM手术的有效后的胃排空改善情况,并进行比较分析。 结果1、完成A组胃三维超声造影方法检查的成功率为97.9%,完成B组上消化道碘水造影检查的成功率为97.8%,两组检查成功率没有统计学差异（P＞0.05）;2、A组检查中胃排空时间明显减少的有效例数为31例,胃排空时间由术前的90（90,90）min减少至术后的30（15,60）min（P＜0.05）,B组检查中胃排空时间明显减少的有效例数为31例,胃排空时间由术前的90（90,90）min减少至术后的30（15,60）min（P＜0.05）。3、A组术前及术后排胃空时间均为90min的16例患者中,90min时间点测量时胃排空率较术前明显改善的有效例数为8例,由术前的61.6%（55.9%,73.6%）增加至术后的78.1%（74.1%,91.6%）（P＜0.05）,胃排空无明显改善的例数为8例（P＞0.05）, B组术前及术后排空时间均为90min的14例患者中,90min时间点测量时胃排空率较术前明显改善的有效例数为5例,由术前的25.0%（25.0%,50.0%）增加至术后的75.0%（70.0%,90.0%） (P＜0.05),胃排空无明显改善的例数为9例（P＞0.05）。4、A组47例超声造影患者中有39例患者的胃排空情况得到了改善（P＜0.05）,其中31例患者的胃排空情况较术前显著改善,8例患者的胃排空情况得到了改善,另8例患者的胃排空情况没有得到改善（P＞0.05）;B组45例碘水造影患者中有36例患者的胃排空情况得到了改善（P＜0.05）,其中31例患者的胃排空情况有明显的改善,5例患者的胃排空情况得到了改善,另9例患者的胃排空情况没有得到改善（P＞0.05）。A、B两组影像学检查评估结果的G-POEM手术后胃排空改善有效率分别为83.0%、80.0%,两组影像学检查结果没有明显差异(P＞0.05)。 结论 胃三维超声容积测定方法及上消化道碘水造影方法均可以对G-POEM前后的胃排空情况进行评价,两种方法的成功率及评估G-POEM手术后的胃排空改善率符合率没有明显差异性,那么由于超声的独特优势（无辐射/操作简便/患者接受度高等）,临床可首选超声胃三维容积检查方法评估G-POEM手术前后的胃排空情况,从而评价G-POEM手术后胃排空功能的改善效果,上消化道碘水造影检查方法作为补充方法,为临床提供客观的影像学数据。     

Shorter Hepatic Transit Time Can Suggest Coming Metastases

Objective. The aim of this study was to assess the value of the hepatic transit time in suggesting coming liver metastases by contrast‐enhanced ultrasonography (CEUS). Methods. Fifty patients with identified liver metastasis (metastasis group [Gmet]), 26 patients without liver metastasis (unclear group [Gunc]) who had proven extrahepatic malignant tumors, and 27 healthy control volunteers (control group [Gcon]) were included in this study. The Gmet group was divided into small and large subgroups. The Gmet group was also divided into pauci and multi subgroups. Every patient was examined by CEUS. The hepatic artery and hepatic vein arrival times were measured, and the difference between them was calculated as the hepatic artery‐vein transit time (HAVTT). Patients in Gunc were given a CEUS examination and an enhanced computed tomography or magnetic resonance imaging examination 3 to 4 months later. Results. The HAVTTs in Gmet were significantly shorter than those in Gcon (P < .05), but there were no statistical differences among the subgroups. A normal cutoff point of 8 seconds in the HAVTTs could distinguish Gmet and Gcon with accuracy, sensitivity, and specificity of 97.40%, 92.59%, and 100%, respectively. As for Gunc, when an HAVTT shorter than 8 seconds was used to predict liver metastasis, the accuracy, sensitivity, and specificity were 92.30%, 100%, and 91.67%. Conclusions. The HAVTT may be a useful tool in monitoring liver micrometastases. If a patient with a primary malignant tumor has a shorter HAVTT, it suggests that an extra examination and additional therapy are needed.     

鼻咽癌肝转移的声像图特征分析

回顾了４５例鼻咽癌肝转移的超声资料和分析了鼻咽癌肝转移的数目、大小、内部回声、形态、在肝脏内的分布、肝脏和脾脏的大小。４５例中，单个病灶５例，２个病灶者３例，３个及３个以上病灶者３７例，分别占１１％、７％和８２％。病灶居右叶者２１例，占４６％。肿瘤大小０．７～８．０ｃｍ不等。６例为低回声，１７例为高回声，１０例中心出现液化性无回声，分别占１３％、３８％和２２％。鼻咽癌肝转移虽然回声表现多样各异，但以肝右叶弥漫性多发大小不等为常见。直径＜１．０ｃｍ的肿瘤以低回声多见。直径位于１．０～３．０ｃｍ者高回声多见，直径＞３．０ｃｍ的转移灶３６％出现囊性变。超声检查尤其可以发现临床尚属隐匿期的鼻咽癌肝转移。     

超声检测肝动脉血流量的动态变化诊断亚临床肝癌的价值

目的借助乙型肝炎肝硬化患者肝动脉血流量(V-HA)的动态变化诊断亚临床肝癌(SHC)的临床价值。方法选取临床诊断为乙型肝炎肝硬化患者150例,应用超声定期检查V-HA,计算复检时V-HA变化幅度(ΔV-HA)占初检V-HA的百分比(ΔV-HA%),采用t检验自身对照。结果150例肝硬化患者中发展为SHC并有完整资料的23例,23例患者的ΔV-HA%初检至癌变前无明显变化(P>0.05),出现SHC时飞跃性增加(P<0.05),且ΔV-HA%均在35%以上。结论超声检测V-HA的动态变化是诊断SHC的可靠参数。     

Color Doppler ultrasound of liver lesions: Signal enhancement after intravenous injection of the ultrasound contrast agent Levovist®

Patients with focal liver lesions (hemangioma, focal nodular hyperplasia, adenoma, hepatocellular carcinoma, metastatic lesions, focal fatty lesion) received the ultrasound contrast agent Levovist® (300 mg/mL and 400 mg/mL) intravenously. This ultrasound contrast agent (a suspension of micrometer-sized microparticles of galactose and microscopic gaseous bubbles) can pass through the lungs without impairment. After the administration of Levovist®, increased color flow signals were detected in the liver. Five of 6 patients with metastatic liver lesions showed previously undetected blood flow in the rim of the tumor. In 4 patients with hepatocellular carcinoma, enhanced signal intensity was observed in the vessels of the rim and in 3 of those patients in the center of the tumor. One patient with adenoma and one patient with focal nodular hyperplasia showed signal enhancement in the central area of the tumor. No signal enhancement was observed in hemangiomas, a focal fatty lesion, or in a carcinoid metastatic lesion. Levovist® increased the echointensity of normal and tumor vessels in liver lesions. This new ultrasound contrast agent led to the detection of tumor vessels previously not detectable by conventional color flow imaging. © 1996 John Wiley & Sons, Inc.     

彩色多普勒超声在21例活体供肝肝移植术后肝动脉并发症中的诊断价值

目的:探讨彩色多普勒超声在活体肝移植术后肝动脉并发症中的诊断价值。方法:回顾分析和总结了21例活体供肝移植术后肝动脉并发症的发生情况及彩色多普勒超声检查结果。结果:超声诊断肝动脉栓塞2例并分别被手术及血管造影证实,误诊肝动脉栓塞1例,被尸体解剖证实,无漏诊病例。误诊肝动狭窄1例。结论:彩色多普勒超声能够早期发现肝动脉栓塞并评价治疗效果,但需注意排出肝动脉栓塞及肝动脉狭窄的假阳性。     

肝包虫病所致梗阻性黄疸的B超诊断

报告３６例肝包虫病所致梗阻性黄疸的声像图改变，其中肝细粒棘球蚴压迫、破入胆道１２例，肝泡状棘球蚴压迫侵犯胆道２４例。对造成梗阻性黄疸的原因及鉴别诊断作了讨论。     

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: Sonographic finding

Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized benign vascular lesion of the spleen. There is limited information regarding its imaging findings of this condition. Until now, the diagnosis was based on histopathologic examination of splenectomy specimens. We report the sonographic findings in a case of SANT of the spleen confirmed by ultrasound‐guided core needle biopsy. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009