肝脏局灶性炎性病变超声造影分析

目的探讨肝脏局灶性炎性病变的超声造影图像特点,提高超声造影对其诊断的准确性。方法对12例经病理证实的肝脏局灶性炎性病变（肝脓肿5例、肝炎性假瘤4例、肝结核3例）行常规超声及超声造影检查,分析肝脓肿、肝炎性假瘤及肝结核病变常规超声及超声造影图像特点。结果肝脓肿、肝炎性假瘤和肝结核的常规超声主要表现为边界模糊（8/12）的低回声病变（11/12）,病灶内可探及动脉血流信号（6/12）。5例肝脓肿因病变阶段不同而有不同的超声造影表现,但3例肝脓肿周围肝实质出现动脉相一过性节段性强化;4例肝炎性假瘤超声造影表现呈＂快进快出＂型,但动脉相呈边界不清的稍高回声强化,缺乏占位感;3例肝结核病灶中央无强化,周边呈结节状或环状强化。结论肝脏局灶性炎性病变超声造影表现变异较大,但每种炎性病变尚具有一定的特点,并且能反映肝脏局灶性炎性病变不同时期的病理改变,超声造影检查有助于提高肝脏局灶性炎性病变诊断的准确性。

Analysis of focal inflammatory lesions of the liver with contrast-enhanced ultrasound

Objective To investigate the features of focal inflammatory lesions of the liver with contrast-enhanced ultrasound （CEUS） and improve the accuracy of diagnosis. Methods Conventional ultrasonography and CEUS were performed in twelve patients with histologically proven focal inflammatory lesions of the liver （ including liver abscess in 5, hepatic inflammatory pseudotumor in 4 and hepatic tuberculosis in 3）. The features of conventional uhrasonography and enhancement patterns of the lesions were analyzed. Results Focal inflammatory lesions of the liver were hypoechoic lesions （11/12） with vague margin （8/12） in conventional ultrasonography. Arterial blood signal can be detected in the lesions （6/12）. The lesions of liver abscess in 5 cases had different enhancement features due to the lesions in different stages, however, transient segmental enhancement of arterial phase was observed in 3 cases in liver parenchyma adjacent to the lesions. The lesions of inflammatory pseudotumor in 4 cases showed a rapid wash-in and rapid washout contrast enhancement pattern, however, the lesions were slightly hyperechoic and ill-defined in arterial phase without space-occupying effect. The lesions of hepatic tuberculosis in 3 cases only showed peripheral globular-nodular or peripheral rim enhancement and center part of the lesions were lack of enhancement during CEUS. Conclusions Though focal inflammatory lesions of the liver had multiple contrast enhancement patterns, each type of focal inflammatory lesions had some enhancement features that could depict their pathologic changes in different stages. CEUS helped to improve the accuracy of diagnosis.