彩色多普勒超声检查、超声造影、增强CT诊断肝脏局灶性结节样增生的比较

目的探讨肝脏局灶性结节样增生(FNH)的彩色多普勒超声检查、超声造影、增强CT表现及其诊断价值。方法 2006～2009年经手术及病理证实的10例FNH患者共14个病灶均行彩色多普勒超声检查,其中8个病灶行超声造影检查,4个病灶行增强CT检查。结果 14个病灶中,彩色多普勒超声检查显示5个病灶(5/14,35.71%)内有轮辐状血流信号,最大血流速度平均为(0.59±0.19)m/s,阻力指数平均为0.46±0.16。超声造影显示5个病灶(5/8,62.50%)出现动脉期早期迅速全瘤强化,其他3个病灶(3/8,37.50%)呈轮辐状离心性快速强化,门脉期及延迟期回声稍高于肝实质或与肝实质等回声,有2个病灶(2/8,25.00%)于延迟期见低回声中央星状瘢痕。增强CT显示4个病灶平扫均呈低密度,动脉期显著均匀性强化,门脉期强化接近于肝实质密度,有2个病灶(2/4,50.00%)于动脉期及门脉期见低密度星状瘢痕。结论彩色多普勒超声、超声造影、增强CT这3种方法结合可大大提高FNH的确诊率。

Comparison of color Doppler imaging,contrast-enhanced ultrasound,contrast-enhanced CT in diagnosis of liver with focal nodular hyperplasia

Objective To evaluate the correlation and value of the color Doppler imaging（CDI）,contrast-enhanced ultrasound（CEUS）,contrast-enhanced CT（CECT） in the diagnosis of liver with focal nodular hyperplasia（FNH）.Methods A total of 10 patients with 14 lesions were examined with CDI,8 of them took CEUS examination and 4 of them with CECT examination.All of them were proved to be FNH by pathological test.Results The color flow with spoke-wheel was detected in 5 lesions（35.71%） by CDFI.The maximum velocity was 0.59 ±0.19 m/s and the resistance index was 0.46±0.16.Five of eight（5/8,62.50%） lesions were early homogeneously hyper-enhanced by CEUS and the other 3 lesions were spoke wheel-like and centrifugal enhanced in the arterial phase,In the portal phase and late phase,all lesions were still hyper-or iso-enhanced.Central scars were detected in 2 lesions.All 4 lesions were enhanced homogeneously in the arterial phase by CECT and the central scars were detected in 2 lesions.Conclusion Combination of CDI,CEUS and CECT are helpful to improve the diagnosis of focal nodular hyperplasia.