超声造影诊断炎症型肝细胞腺瘤的临床应用

目的:探讨炎症型肝细胞腺瘤(inflammatory hepatocellular adenoma，I-HCA)的超声造影(contrast-enhanced ultrasound，CEUS)特征。方法:回顾性分析2009年4月至2019年11月在复旦大学附属中山医院经病理及免疫组织化学证实的28例I-HCA患者28个...

Clinical application of contrast-enhanced ultrasound in inflammatory hepatocellular adenoma

Objective To investigate the contrast-enhanced ultrasound(CEUS)features of inflammatory hepatocellular adenoma(I-HCA).Methods The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital,Fudan University were retrospectively analyzed,including arterial phase enhancement pattern,the homogeneity of enhancement,subcapsular enhancement,and the internal perfusion defect.All I-HCA lesions were divided into>5 cm group(n=9)and≤5 cm group(n=19),the CEUS features between the two groups were compared.Results All I-HCA lesions were hyper-enhanced in the arterial phase,among which 39.3%(11/28)showed diffuse filling,39.3%(11/28)showed centripetal filling,and 21.4%(6/28)showed centrifugal filling pattern.Twenty-five percent(7/28)of I-HCAs showed heterogeneous enhancement,10.7%(3/28)revealed unenhanced areas within the lesions.Subcapsular vessels were observed in 67.7(21/31)of I-HCA lesions.Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions>5 cm(P=0.020,0.026,respectively),while there was no difference in the enhancement pattern and subcapsular vessels between the two groups(P>0.05).Inportal venous phase,42.9%(12/28)of I-HCAs showed hypo-enhancement,and 57.1%(16/28)of lesions showed washout in late phase.According to"hyper-enhancement in arterial phase,sustained hyper-or iso-enhancement in portal venous and late phase"by CEUS,the diagnostic accuracy of benign lesion was 42.9%(12/28).According to any of hyper-enhancement pattern in arterial phase,subcapsular vascular enhancement,and sustained hyper-or iso-enhancement in portal venous and late phase,the diagnostic accuracy of I-HCA was 71.4%(20/28).Conclusions CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.