超声造影对脂肪肝背景下肝内局灶性病变的鉴别诊断价值

目的：探讨超声造影对脂肪肝背景下肝内局灶性病变的鉴别诊断价值。方法对我院2008—2011年常规体检中发现的70例脂肪肝背景下肝内局灶性病变患者进行二维超声、彩色多普勒超声、超声造影检查，并对诊断结果进行比较。结果超声造影检查诊断为血管瘤41例，非均匀性脂肪肝10例，肝局灶性结节增生（FNH）6例，炎性假瘤6例，自发性血肿2例（误诊1例），腺瘤2例，炎性病灶1例，脂肪肝合并恶性肿瘤（MT）1例，片状高回声性质待定1例。超声造影对于脂肪肝背景下肝内局灶性病变诊断准确率为97.1％（68/70），高于二维超声结合彩色多普勒超声的52.9％（37/70），血管瘤29例，非均匀性脂肪肝7例，FNH 1例，差异有统计学意义（ P 〈0.01）。结论超声造影对于脂肪肝背景下肝内局灶性病变具有鉴别诊断价值，对于缺少特异性表现的部分患者需采用穿刺活检明确诊断。

Differential Diagnosis Value of Contrast - enhanced Ultrasonography on Liver Focal Disease under the Background of Fatty Liver

Objective To study the differential diagnosis value of contrast - enhanced ultrasonography on liver focal disease under the background of fatty liver. Methods Between 2008 and 2011,70 cases with liver focal disease under the background of fatty liver were selected in physical examination in our hospital,they all underwent two - dimensional ultrasound, color Doppler ultrasound and contrast - enhanced ultrasonography. The examination results were compared. Results Contrast- enhanced ultrasonography found 41 cases with hemangioma,10 cases with non - uniform fatty liver,6 cases with FNH,6 ca-ses with inflammatory pseudotumor,2 cases with spontaneous hematoma（thereinto 1 case was misdiagnosis）,2 cases woth ade-noma,1 case with inflammatory lesions,1 case with fatty liver and MT,1 case with flake high echo properties（ undeter-mined）. The diagnosis accuracy rate of contrast - enhanced ultrasonography on liver focal disease under the background of fatty liver was 97. 1% （68 / 70）,was higher than that of two - dimensional ultrasound combined with color Doppler ultrasound of 52. 9% （37 / 70）,the difference was statistically significantly different（P 〈 0. 01）,while the latter found 29 cases with he-mangioma,7 cases with non - uniform fatty liver,1 case with FNH. Conclusion Contrast - enhanced ultrasonography has certain differential diagnosis value on liver focal disease under the background of fatty liver,for those patients lacking of specific manifestations need aspiration biopsy.