超声造影对肝脏局灶性脂肪浸润或缺失的诊断价值

目的探讨CEUS对肝脏局灶性脂肪浸润或缺失的诊断价值。方法回顾性分析76例肝脏局灶性脂肪浸润或缺失病例,其中3例经病理学证实,73例经增强CT/增强MRI确诊并随访6个月以上。所有病例均接受常规二维超声及CEUS检查。结果 76例病例中,71例(71/76,93.42%)表现为动脉期、门静脉期及实质期三期等增强,4例(4/76,5.26%)表现为动脉期轻度高增强、门静脉期及实质期等增强,1例(1/76,1.32%)类似肝癌的动脉期高增强、门静脉期及实质期低增强。CEUS诊断局灶性脂肪浸润或缺失与病理或其他检查随访结果的差异无统计学意义(P=0.0625),二者具有相关性(r=0.65,P<0.001)。二维声像图上三期等增强组与动脉期高增强组病灶回声、边界和形态的差异均无统计学意义(P均>0.05)。结论 CEUS对局灶性脂肪浸润或缺失的诊断具有较高的准确率。

Value of contrast enhanced ultrasound for liver focal fatty infiltration or sparing

Objective To explore the value of contrast enhanced ultrasound (CEUS) for liver focal fatty infiltration or sparing and the contrast-enhanced feature. Methods Seventy-six patients with focal fatty infiltration or sparing underwent gray-scale ultrasound and CEUS were analyzed retrospectively, i.e. 3 cases were confirmed by pathology and 73 cases were confirmed by enhanced CT or MRI and followed for 6 months at least. Results Among the 76 cases, 71 cases (71/76, 93.42%) revealed isoenhancement in the three phases (arterial phase, portal venous phase and parenchymal phase), 4 cases (4/76, 5.26%) revealed hyperenhancedment in arterial phase and 1 case (1/76, 1.32%) mimic hepatic carcinoma as hyperenhancement in arterial phase, hypoenhancement in portal venous phase and parenchymal phase. There is no significant difference between CEUS diagnosis and the standard diagnosis (pathology or enhanced CT/MRI) for focal fatty infiltration or sparing (P=0.0625), the correlation coefficient was 0.65 (P<0.001). Furthermore there was no significant difference of gray-scale ultrasound features such as morphology, echo and boundary between patients with isoenhancement in three phases and hyperenhancedment in arterial phase on CEUS image (all P>0.05). Conclusion CEUS has a high accuracy in diagnosis of liver focal fatty infiltration or sparing.