肝海绵状血管瘤不同超声造影表现机制初探

目的探讨肝海绵状血管瘤(cavernous hemangiomas of the liver,CHL)超声造影(contrast enhance ultrasound,CEUS)不同强化形式产生的机制。方法经左肘静脉团注造影剂SonoVue2.4ml,观察5min,重点观察强化形式、时相、有无消退。结果37例44个病灶,根据强化形式分为4型,分别为型:结节状环形渐进性强化。型:细环状非渐进性强化。型:快速整体强化无消退。型:稀疏树枝状强化略消退。CHL造影表现与血流动力学密切相关,而血流动力学改变源自病理特征。当CHL窦腔大小不一时,CEUS呈环形渐进性强化,即所谓“早出晚归“的典型强化表现。因多数病例窦腔大小不等,故造影多呈此种表现。若CHL为均一细小血窦(直径<50μm),常为高血流动力学改变,呈整体快速强化。当CHL窦腔明显增大,或窦腔内血栓形成、纤维化、透明样变、钙化时,CHL内血流量明显减少,甚至窦腔内无血流进入。窦腔间有小动脉穿行,强化时呈“树枝“状改变。结论CHL窦腔的大小是否均一,有无纤维化钙化等病理特点及由此产生的血流动力学改变,是CEUS不同强化形式产生的基础。

Investigation of the Different Forms of Contrast Enhance Ultrasound for Cavernous Hemangiomas of Liver

Objective To investigate the mechanism of the different forms of the contrast enhance ultrasound(CEUS) for cavernous hemangiomas of liver(CHL).Methods Contrast medium SonoVue 2.4 mL was injected through the left elbow vein.The enhanced form,phase and whether there was extinction were observed for 5 min utes.Results Thirty-serven patients(44 focuses of infection) were divided into 4 types according to the enhanced forms.Type I was nodular ring-like gradation enhancing.Type II was ring-like non-gradation enha...