影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (4): 708-712.DOI: 10.7517/issn.1674-0475.200106

• 综述与论文 • 上一篇    下一篇

回顾性分析不同病理类型肝脏恶性肿瘤超声造影表现

王琴, 王金萍, 王佳佳, 李保启   

  1. 安徽中医药大学第一附属医院 超声医学科, 安徽 合肥 230031
  • 收稿日期:2020-01-13 出版日期:2020-07-15 发布日期:2020-07-15
  • 基金资助:
    安徽中医药大学校级科研项目(2018zryb27)和安徽省2018年度重点研究与开发计划项目(1804h08020248)

Retrospective Analysis of Contrast-Enhanced Ultrasound Findings of Hepatic Malignancies of Different Pathological Types

WANG Qin, WANG Jinping, WANG Jiajia, LI Baoqi   

  1. Department of Ultrasound Medicine, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui, P. R. China
  • Received:2020-01-13 Online:2020-07-15 Published:2020-07-15

摘要: 本文旨在探讨超声造影(CEUS)在不同病理类型肝脏恶性肿瘤中的鉴别诊断价值。回顾性分析经病理证实的38例肝脏恶性肿瘤超声造影表现,并与组织病理学结果比较。结果示38例患者中有肝细胞性肝癌(HCC)12例、肝内胆管细胞癌(ICC)8例、转移性肝癌(MLC)18例,其超声造影几乎均呈"快进快出"灌注特征。动脉相:HCC均呈快速整体高增强;ICC大部分呈不均匀高增强(75.0%),部分呈"轮辐征"(50%);MLC呈整体高增强(55.6%)或周边厚圈样增强(44.4%)。门脉及延迟相:快速消退呈低增强(89.5%)或无增强(7.9%)。不同肿瘤开始增强、达峰及开始消退时间均存在差异(P<0.001),由快到慢依次为转移性肝癌、肝内胆管细胞癌、肝细胞性肝癌。说明大多数肝脏恶性肿瘤在超声造影中都有一定的特征性表现,在鉴别诊断中具有重要价值。

关键词: 病理, 肝脏恶性肿瘤, 超声造影

Abstract: The purpose of this article is to explore the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of hepatic malignancies of different pathological types. CEUS findings of 38 cases of hepatic malignancies confirmed by pathology were analyzed retrospectively and compared with histopathological results. There were 12 cases of Hepatocellular carcinoma (HCC), 8 cases of intrahepatic cholangiocarcinoma (ICC) and 18 cases of metastatic liver cancer (MLC) in 38 patients, of whom CEUS almost showed perfusion characteristics of "fast in and fast out". In the arterial phase:HCC showed rapid total hyper-enhancement; ICC showed uneven and high enhancement (75.0%), and some showed a "spoke sign" (50%); MLC showed total hyper-enhancement (55.6%) or thick rim-like hyper-enhancement (44.4%). In the portal phase and delayed phase:Rapid regression presented hypo-enhancement (89.5%) or non-enhancement (7.9%). There were differences in the time of enhancement, peak and regression in different tumors (P<0.001). According to the order from fast to slow, they were MLC, ICC, and HCC respectively.In summary, most hepatic malignancies have certain characteristic manifestations in contrast-enhanced ultrasound and are of great value in differential diagnosis.

Key words: pathology, hepatic malignancy, contrast-enhanced ultrasound