肝内胆管细胞癌超声造影表现

目的总结肝内胆管细胞癌的超声造影表现.方法回顾性分析2009年1月至2011年12月复旦大学附属中山医院收治的经手术及穿刺活检病理证实的56例肝内胆管细胞癌患者超声造影表现.结果56例肝内胆管细胞癌患者共70个病灶,所有病灶超声造影均表现为“快进快出”,门脉期及延迟期均呈低回声.肝内胆管细胞癌超声造影开始增强时间、达峰时间、表现为等回声时间、表现为低回声时间分别为(14.50±3.82)s、(22.29±4.97)s、(30.38±7.97)s、(43.54±16.80)s.70个病灶中,42个(60.0%,42/70)表现为动脉期病灶边缘不规则环状增强,28个(40.0%,28/70)表现为整体增强;动脉期增强过程中,49个病灶(70.0%,49/70)表现为“树枝状”由周边向中央延伸的特征性的增强方式.超声造影增强达峰值时,51个病灶(72.9%,51/70)表现为不均匀增强,19个(27.1%,19/70)表现为均匀增强.21个病灶(30.0%,21/70)常规二维超声检查病灶边界显示不清,超声造影病灶边界均清晰.所有病灶在门脉期及延迟期均表现为低回声.56个病灶(80.0%,56/70)超声造影表现为“快进快出”、环状增强和(或)树枝状增强.结论肝内胆管细胞癌的超声造影具有“快进快出”、环状增强和(或)树枝状增强等表现,对其诊断和鉴别诊断具有一定的价值.     

肝内胆管细胞癌超声造影的特征及其病理基础

目的 从病理学角度探讨肝内胆管细胞癌的超声造影特征,提高该病超声诊断准确率.方法 对11例患者进行常规超声及超声造影检查,记录病灶常规超声表现及肿块造影各时相灌注特点.结果 常规超声示病灶大部分呈低回声,边界不清.CDFI表现少血供型为主.超声造影显示:动脉相表现为病灶呈不均匀增强,呈现周边厚环状、内部稀拉羽毛状高增强为特征.门脉相为造影剂快速退出.延迟相为病灶呈低增强的灌注特点,但强弱分布不均匀.结论 胆管细胞癌超声造影的灌注模式,正是基于该病的病理基础所决定的.     

肝局灶性炎性病变的超声造影增强表现

目的探讨肝局灶性炎性病变超声造影的增强表现。方法采用造影剂SonoVue和对比脉冲序列成像技术对肝脓肿、炎性假瘤、胆管周围炎症、肝结核和真菌感染共58个肝局灶性炎性病灶施行了超声造影检查。观测病灶的增强水平、形态以及随时相变化的特点。结果32个肝脓肿病灶在动脉期呈现高增强、等增强和低增强分别为26个、5个和1个;30个病灶为周边环状增强伴中央无增强,其中22个见内部分隔状增强;20例显示动脉早期病灶所在区域肝组织楔形高增强;26个高增强病灶至门脉期14个、至延迟期共21个消退至低增强;5个等增强病灶至门脉期3个、至延迟期共4个消退至低增强。5例胆管周围炎症者动脉期表现为不均匀高增强（3例）或等增强（2例）,门脉期及延迟期所有病灶减退至低增强。19个炎性假瘤病灶动脉期高增强、等增强和低增强分别为11个、3个和5个,其中12个具有周边环状增强的特点,门脉期及延迟期所有病灶均表现为低增强。1个肝结核病灶和1个真菌感染炎性病灶动脉期均呈不均匀高增强,门脉期及延迟期亦减退至低增强。结论肝脓肿病灶大多数在门脉期为低增强,与欧洲指南所描述的典型表现有所不同。胆管周围炎和局灶性非化脓性炎症病变则表现出在动脉期高增强或等增强后,门脉期及延迟期消退为低增强,与恶性肿瘤的增强模式相似。     

具有肝硬化基础的肝内胆管细胞癌的超声造影及增强CT的增强模式分析

目的 探讨在肝硬化基础上的肝内胆管细胞癌的实时超声造影与增强螺旋CT的成像特征.方法 经病理确诊的胆管细胞癌并肝硬化的患者12例(手术切除11例,穿刺1例),11例采用对比脉冲造影技术,1例采用连续脉冲反向谐波造影技术,机械指数<0.2,2.4 mL造影剂SonoVue团注.将超声造影与增强CT的增强模式、术前诊断与病理结果进行对比分析.结果 超声造影动脉相5例(41.7%)为不均匀高增强,3例(25.0%)为均匀高增强,4例(33.3%)为周边环状增强.超声造影3例(25.0%)诊断为肝内胆管细胞癌,9例(75.0%)诊断为肝细胞癌.增强CT动脉期10例(83.3%)为不均匀强化,2例(16.7%)为环状强化.2例(16.7%)诊断为肝内胆管细胞,10例(83.3%)诊断为肝细胞癌.结论 肝硬化基础上的多数肝内胆管细胞癌实时超声造影与增强螺旋CT的增强模式与肝细胞癌类似,影像学鉴别诊断困难.     

外周型肝内胆管细胞癌8例MRI表现及误诊分析

目的分析外周型肝内胆管细胞癌（PCC）的MRI表现及其误漏诊原因。方法回顾性分析8例MR检查被误漏诊的PCC,均经手术病理证实,所有病例均做了MRI平扫、磁共振胰胆管造影（MRCP）和动脉期、门脉期、延迟期增强扫描。结合手术及病理所见分析其MRI表现及误诊原因。结果 8例PCC磁共振成像均未显示具体肿块影,肝左叶胆管走向僵直、截断及病灶内胆管扩张。平扫T1WI见低信号灶,T2WI信号改变不明显,弥散加权像（DWI）呈高信号;增强扫描动脉期病灶无强化,门脉期、平衡期及延迟期均呈不均匀轻/中度强化。其他表现包括肝内小转移灶3例,腹膜后淋巴结转移者5例,均无门静脉癌栓。结论 MRI检查信号改变、强化特征不明显的PCC极易误诊,需仔细观察胆管扩张的形态改变及动态增强特点,结合DWI像做出诊断。     

胆管内乳头状肿瘤超声及超声造影表现

目的 探讨胆管内乳头状肿瘤(intraductal papillary neoplasm of bile duct,IPN-B)的常规超声及超声造影表现.方法 回顾性分析8例经病理确诊的IPN B患者共9个病灶的常规超声和超声造影表现.超声造影采用SonoVue造影剂和低机械指数连续实时成像技术.结果 常规超声5个病灶表现为“胆道扩张型”,即胆管内有乳头状肿物4例、菜花状肿物1例,均有肝内外胆管不同程度扩张,血供稀少;3个病灶表现为“囊实混合型”肿物,实性病灶内可见多个小片状无回声区,病灶均与周围轻度扩张胆管相通,血供丰富或稀少;超声造影8个病灶实性成分具有动脉期均匀或不均匀高增强,门脉期、延迟期减退为低增强的特点,1个病灶超声及超声造影未见明确肿瘤性病变.结论 胆管内乳头状肿瘤超声及超声造影检查术前诊断率低,需进一步提高对该病的认识,常规超声发现扩张的胆管内有乳头状结节或菜花状肿物,超声造影提示动脉期呈高增强,门脉期、延迟期减退为低增强,需考虑胆管内乳头状肿瘤的诊断.     

肝内胆管细胞癌超声造影研究

目的 探讨低机械指数实时超声造影技术应用于肝内胆管细胞癌(intrahepatic cholangiocarcinama,ICC)的造影表现及诊断价值.方法 通过常规超声及超声造影技术(contrast enhanced ultrasound,CEUS)对22例患者肝内的29个病灶进行检查,记录病灶二维超声特点,观察超声造影各时相增强特点,并与病理结果进行对照,然后进行统计分析.结果 (1)肝内胆管细胞癌二维超声表现多样.(2)超声造影动脉相共观察到4种增强模式:①动脉相病灶整体高增强(20.69％);②动脉相不均质稍高增强(55.17％);③动脉相呈不均质低增强,中心大部分区域呈无增强,仅见树枝状稀疏血管伸入其中(10.34％);④动脉相呈周边环状高增强(1 3.8％).(3)病灶增强模式与病灶大小关系:长径≤2.5 cm的病灶动脉相多呈整体高增强,＞2.5 cm的病灶则以不均质稍高增强为主(P＜0.000 1).长径≤2.5 cm的病灶门脉相多呈低增强,＞2.5cm者多呈等增强(P＜0.000 1);延迟相:病灶均呈低增强表现.(4)超声造影动脉相高增强部分,病理结果显示其内癌细胞较多,血管较丰富.造影示动脉相浅淡增强或充盈缺损部分,病理表现其成分以纤维组织为主,其内稀疏分布的血管,同时可见灶状坏死.结论 ICC超声造影表现具有一定的特征性,超声造影技术对其诊断具有重要价值.     

肝移植缺血性胆道病变的超声造影研究

目的 探讨实时超声造影技术诊断肝移植术后缺血性胆道病变(ITBL)的临床应用价值.方法 25例经内镜下逆行性胰胆管造影或经皮肝穿刺胆道造影确诊,超声疑为胆道并发症的移植肝接受超声造影检查.以增厚最明显的肝门部胆管壁为观察目标,分析胆管壁增强特点.结果 胆管壁造影表现可分3类:①胆管壁无增强者6例,即胆管壁在动脉期、门脉期及延迟期均无增强;②胆管壁低增强水平者4例,即胆管壁在动脉期呈低增强,门脉期及延迟期持续低增强或消退为无增强;③胆管壁高增强水平者15例,即胆管壁在动脉期呈高或等增强,门脉期及延迟期消退为等或低增强.25例确诊病例中包括13例ITBL和12例非ITBL.ITBL组胆管壁无或低增强水平者10例(76.9%),高增强水平者3例(23.1%);非ITBL组均为高增强水平者,两组间差异有统计学意义(P=0.00).结论 超声造影检测胆管壁微循环灌注具有可行性,有可能为临床提供一种全新的从微血管层面诊断ITBL的影像学手段.     

肝淋巴瘤超声造影表现

目的 探讨肝淋巴瘤的超声造影特点.方法 回顾性分析4例经穿刺活检病理证实的肝淋巴瘤患者的超声造影资料.结果 4例肝淋巴瘤中2例为原发性肝淋巴瘤,1例表现为动脉期快速整体高增强,门静脉期造影剂逐渐退出,实质期造影剂基本廓清;另1例表现为动脉早期周边呈粗环状高增强,并且造影剂从周边快速向中心填充至整体高增强,动脉晚期周边高增强部分开始消退,门静脉期周边呈低增强,中心呈高增强,实质期造影剂廓清.2例为继发性肝淋巴瘤,均表现为动脉期整体呈稍高增强,门静脉期造影剂轻度退出,实质期造影剂继续退出至完全廓清.结论 肝淋巴瘤超声造影表现为"快进快退"模式,类似于多种恶性肿瘤超声造影表现,需结合临床资料进行综合分析.     

超声造影在肝恶性肿瘤鉴别诊断中的应用价值

目的 探讨实时超声造影在肝恶性占位病变中的鉴别诊断应用价值.方法 对66例经手术或超声引导穿刺活检病理确诊的肝恶性占位(原发性肝癌32例,转移性肝癌20例,肝内胆管细胞癌14例),观察肝脏恶性占位病变在超声造影中的增强方式,增强时间,以及时间-强度曲线分析,术前进行超声造影与术后病理结果进行比较分析.结果 就增强方式而言,原发性肝癌动脉相早期呈整体增强,转移性肝癌动脉相早期呈整体增强或周边厚圈状增强,廓清后呈"黑洞"表现,肝内胆管细胞癌呈整体增强.增强时间及强度而言,肝恶性肿瘤均表现为快进快出型,但转移性肝癌的廓清时间更快;原发性肝癌增强强度呈高强度,转移件肝癌呈低强度,而肝内胆管细胞痛则呈等强度.结论 实时超声造影可准确显示大多数肝恶性占位病变的不同灌注特点,通过时间-强度曲线分析可定量检测病灶在造影过程中随时间不同增强强度的变化,从而对肝恶性肿瘤作出正确的定性诊断.     

The analysis of enhancement pattern of hepatic inflammatory pseudotumor on contrast-enhanced ultrasound

Objective

The aim of this study was to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of hepatic inflammatory pseudotumor (IPT).

Methods

We retrospectively reviewed 36 cases of histopathologically diagnosed IPT. Nodule enhancement appearances during the arterial, portal, and delayed phases were defined as hyperenhancement, isoenhancement, hypoenhancement, and non-enhancement compared with the surrounding liver parenchyma. Statistical analysis was performed by the one-way ANOVA and χ ² tests.

Results

Among total 36 cases, 7 nodules were absent of contrast enhancement during all three phrases on CEUS. Twenty-nine nodules appeared different forms of enhancement in arterial phase. Diffuse homogeneous hyperenhancement, diffuse heterogeneous hyperenhancement, peripheral rim-like enhancement, and diffuse iso-enhancement were found in 10, 12, 5, and 2 of the nodules, respectively. Twenty-five nodules showed hypoenhancement in portal and delayed phases. Four nodules showed contrast washed out synchronously with normal liver parenchyma. The median time to enhancement, median time to peak, and median time to wash out of the nodules were 17 s (range 11–28 s), 23 s (range 14–42 s), and 45 s (range 23–100 s), respectively. No statistical significant differences were found in the above parameters of nodule enhancement and proportion of enhancement patterns when dividing the nodules into subgroups by nodule size.

Conclusion

IPT displays a variety of enhancement patterns due to pathological changes in the course of disease progression. Some characteristics on CEUS may be helpful in the differential diagnosis of IPT.     

超声造影对肝内胆管细胞癌的诊断价值

目的探讨肝内胆管细胞癌的超声造影征象及临床应用价值.方法对3例病理证实的胆管细胞癌分别行常规超声及实时灰阶谐波超声造影检查,记录病灶的大小、回声、血流分布及分析超声造影各时相的特征.结果 3例病灶在二维声像图上没有特异性,彩色多普勒血流显像显示病灶均为少血供型,超声造影显示3例病灶均表现"快进快出"的超声造影增强模式,门脉相病灶呈低回声,周边可见高回声环.结论超声造影在本组肝内胆管细胞癌病例中表现出的共同特征,对病灶的诊断有一定帮助.     

肝内胆管细胞癌超声造影增强模式探讨

目的分析肝内胆管细胞癌（ICC）的超声造影增强模式,探讨其诊断价值。方法38例ICC患者,共38个病灶,注射超声造影剂SonoVue后分析病灶增强水平与增强方式。结果ICC病灶直径1．7-9．6cm,平均（5．6±2．2）cm。动脉相增强模式：均匀高增强5个,不均匀高增强10个,均匀低增强1个,不均匀低增强13个,环状增强6个,部分增强2个,均匀等增强1个。门脉相：低增强36个,等增强2个。延迟相：38个均表现低增强。14个病灶在注射造影剂45s内开始消退,22个在45～120S消退,2个在120S后消退。结论ICC超声造影表现为动脉相多种增强模式,与病灶大小有一定相关性。     

Characterization of focal liver lesions using contrast-enhanced sonography with a low mechanical index mode and a sulfur hexafluoride-filled microbubble contrast agent

PURPOSE: To characterize focal liver lesions (FLLs) using real-time contrast-enhancedsonography (CEUS) with a low mechanical index mode and a sulfur hexafluoride-filled microbubble contrast agent. METHODS: CEUS was performed in 190 patients with FLLs, including hepatocellular carcinoma (HCC) (n = 107), liver metastasis (n = 21), intrahepatic cholangiocarcinoma (ICC) (n = 7), liver hemangioma (n = 37), focal nodular hyperplasia (FNH) (n = 11), regenerative nodule (n = 6) and liver lipoma (n = 1). The cadence contrast pulse sequencing technique and the contrast agent SonoVue(R) were used for CEUS examination. The enhancement patterns during the arterial, portal, and late phases were evaluated. RESULTS: HCC showed hyperenhancement in 100 (93.5%) of 107 nodules during the arterial phase and hypoenhancement in 102 (95.3%) during the late phase. Liver metastases showed homogeneous enhancement in 8 of 21 (38.1%) nodules and a peripheral regular rim-like enhancement in 11 of 21 (52.4%) nodules during the arterial phase and marked hypoenhancement in 16 of 21 (76.2%) nodules during the late phase. ICC exhibited irregular rim-like enhancement in 4 of 7 (57.1%) nodules during the arterial phase and hypo-enhancement in 7 of 7 (100%) nodules during the late phase. Hemangioma showed peripheral nodular hyperenhancement, and progressive centripetal enhancement was seen in 35 of 37 (94.6%) lesions during the arterial phase. All 11 cases of FNH exhibited homogeneous hyperenhancement during the arterial phase and hyperenhancement (n = 1) or isoenhancement (n = 9) during the late phase. The sensitivity, specificity, and positive predictive value, respectively, were 88.8%, 89.2%, and 91.3% for HCC; 81%, 100%, and 100% for liver metastasis; 57.1%, 100%, and 100% for ICC; 94.6%, 100%, and 100% for liver hemangioma; and 90.9%, 97.8%, and 71.4% for FNH. CONCLUSIONS: Low-mechanical index CEUS permits real-time, complete assessment of vascularity in FLLs, which in turn facilitates their characterization.     

肝门部胆管癌超声造影与增强MRI增强模式的对比研究

目的 探讨肝门部胆管癌超声造影(CEUS)及增强MRI(CEMRI)增强模式的影像学特征.方法 对21例手术病理证实为肝门部胆管癌患者的术前超声造影及增强MRI图像中病灶的增强水平及增强形态进行比较.结果 (1)21例肝门部胆管癌病灶超声造影动脉期多显示为高增强(14/21,66.7%),门脉期(19/21,90.5%)及延迟期多消退为低增强(21/21,100%);显示病灶增强均匀8个(8/21),不均匀13个(13/21).(2)21例肝门部胆管癌病灶增强MRI动脉期多显示为高增强(14/21,66.7%),门脉期以等增强为主(11/21,52.4%),延迟期多显示为等增强(6/21,28.6 %)或高增强(12/21,57.1%);显示病灶增强均匀6个(6/21),不均匀15个(15/21).(3)肝门部胆管癌超声造影动脉期显示不同增强水平的病灶数与增强MRI比较差异无统计学意义(χ2=1.167,P>0.05);超声造影门脉期及延迟期与增强MRI增强水平显示的病灶数比较差异有统计学意义(χ2=24.867、31.500,P<0.05).肝门部胆管癌病灶超声造影与增强MRI显示增强均匀性的病灶数比较差异无统计学意义(χ2=0.429,P>0.05).结论 肝门部胆管癌在超声造影及增强MRI动脉期表现无明显差异,而门脉期及延迟期的表现则不同,超声造影可作为增强MRI诊断肝门部胆管癌的有益补充,从而增加诊断医师对肝门部胆管癌的诊断信心.     

Imaging of peripheral cholangiocarcinoma with low-mechanical index contrast-enhanced sonography and SonoVue: initial experience.

OBJECTIVE: The purpose of this study was to investigate the imaging findings of peripheral cholangiocarcinoma with low-mechanical index (MI) contrast-enhanced sonography. METHODS: Eighteen nodules of peripheral cholangiocarcinoma proved by pathologic examination in 18 patients were evaluated with contrast-enhanced sonography. A low-MI real-time contrast-enhanced sonographic mode (ie, contrast pulse sequencing) and a sulfur hexafluoride-filled microbubble contrast agent (SonoVue [BR1]; Bracco SpA, Milan, Italy) were used. RESULTS: On contrast-enhanced sonographic images, all 18 nodules (100%) of peripheral cholangiocarcinoma showed inhomogeneous enhancement during the arterial phase, and the emergence of nodule enhancement was earlier in 3 nodules (16.7%), simultaneous in 13 (72.2%), and later in 2 (11.1%), respectively, when compared with the adjacent liver tissue. During the arterial phase, 8 nodules (44.4%) showed irregular peripheral rimlike hyperenhancement, 2 (11.1%) showed inhomogeneous hyperenhancement, and 8 (44.4%) showed inhomogeneous hypoenhancement. In portal and late phases, all 18 nodules (100%) showed hypoenhancement. When contrast-enhanced sonography was added for analysis, the confidence levels of the investigators were improved in 15 (83.3%) of 18 nodules, and 17 (94.4%) of 18 peripheral cholangiocarcinomas were correctly characterized. CONCLUSIONS: The imaging findings of peripheral cholangiocarcinoma had some characteristics on low-MI contrast-enhanced sonography. Knowledge of these characteristics might be beneficial for improving the diagnostic performance of sonography in evaluating this entity.     

周围型肝内胆管细胞癌:超声造影与增强CT对照

目的 比较周围型肝内胆管细胞癌(ICC)的CEUS与增强CT特点。方法 回顾性分析经手术及病理证实的30例ICC患者(36个病灶)的CEUS及增强CT表现,采用Kappa一致性检验评估两种检查方法诊断的准确率。结果 CEUS显示36个病灶均为动脉期增强,门静脉期及延迟期回声减弱,呈"快进快出"型。增强CT动脉期图像示36个病灶均强化,28个门静脉期及延迟期持续强化,另8个门静脉期及延迟期强化程度减退。CEUS显示19个病灶(19/36,52.78%)周边部环状增强,17个(17/36,47.22%)整体增强;21个(21/36,58.33%)表现为"树枝样"向内延伸。增强CT显示22个病灶(22/36,61.11%)周边环状强化,其中5个呈分隔样强化;14个(14/36,38.89%)为整体强化。达峰值时,CEUS示23个病灶不均匀增强,13个均匀增强;增强CT示20个病灶不均匀增强,16个均匀增强。以"快进快出"、环状增强和(或)"树枝样"增强作为CEUS诊断ICC的标准,CEUS的诊断准确率为70.00%(21/30);以动脉期"环状强化",门静脉期及延迟期"持续强化"作为CT诊断ICC的标准,增强CT的诊断准确率为73.33%(22/30);Kappa一致性检验显示两种检查方法具有很好的一致性(Kappa值＝0.824)。结论 周围型ICC的CEUS与增强CT表现具有一定特征性;两种方法对于周围型ICC均有较高诊断价值。     

The current status of contrast-enhanced ultrasound in China

This review article provides an overview of the use of contrast-enhanced ultrasound (CEUS) in China. Currently, the only licensed contrast agent is SonoVue, a sulfur hexafluoride-filled microbubble contrast agent. In combination with a low mechanical index contrast-specific imaging mode, SonoVue-enhanced CEUS can be used to visualize the micro and macro-vasculature continuously. Since 2004, CEUS has been widely used in China in various clinical scenarios. The authors compared CEUS with baseline ultrasound or contrast-enhanced computed tomography with regard to characterization of focal liver lesions (FLLs). On CEUS, heterogeneous or homogeneous hyperenhancement during the arterial phase and washout in the portal/late phase are typical findings for hepatocellular carcinoma. The enhancement features of intrahepatic cholangiocarcinoma, infected FLLs, focal fatty infiltration, focal fatty sparing, complex cystic FLLs, and uncommon benign FLLs were carefully depicted. CEUS was also used for patient selection in ablation therapy and evaluation of response to ablation for liver cancer. The utility of three-dimensional CEUS of the liver was also explored. In non-liver use, CEUS in hilar cholangiocarcinoma, gallbladder, breast, and prostate was initially investigated. In addition, CEUS was used in interventional procedures such as CEUS-guided hemostatic injection, intraoperative CEUS in neurosurgery, and evaluation of response to high-intensity focused ultrasound ablation of uterine fibroids. The Chinese experience has resulted in increased use of CEUS.     

肝门部胆管癌超声造影与增强CT的对比研究

目的 探讨肝门部胆管癌超声造影(CEUS)和增强CT(CECT)特征及其应用价值.方法 32例经病理确诊的肝门部胆管癌患者共32个病灶同时接受了CEUS和CECT检查.CEUS采用造影剂声诺维和低机械指数实时超声成像技术.CECT采用造影剂优维显和常规双期增强扫描.结果 动脉期,肝门部胆管癌在CEUS和CECT上分别有14个(43.8%)和12个(37.5%)病灶表现为高增强,14个(43.8%)和9个(28.1%)等增强,4个(12.5%)和11个(34.4%)低增强(P=0.162);CEUS和CECT分别有3个(9.4%)和2个(6.3%)病灶表现为周边环状高增强,29个(90.6%)和30个(93.8%)为全瘤均匀(11个和9个)或不均匀(18个和21个)增强(P=1.000).门脉期,CEUS和CECT上分别有30个(93.8%)和23个(71.9%)病灶表现为低增强,1个(3.1%)和8个(25.0%)等增强,1个(3.1%)和1个(3.1%)高增强(P=0.046).普通超声、CEUS及CECT判断门静脉浸润准确率分别为84.2%(16/32)、89.5%(17/32)和78.9%(15/32).术前CEUS及CECT作出正确诊断的分别为30例(93.8%)和25例(78.1%)(P=0.125).结论 肝门部胆管癌在CEUS与CECT动脉期表现类似,门脉期CEUS更倾向于表现为低增强.术前CEUS与CECT对肝门胆管癌定性诊断能力相似.