肝巨大血管瘤超声造影表现及其诊断

摘要

Objective To explore the enhancement pattern and characterization of hepatic hemangionmas with contrast enhanced ultrasound (CEUS).Methods A total of 44 patients with 49 nodules preliminary diagnosed of liver hemangioma were included in this study.For each nodule,the enhancement pattern,level,and dynamic change of CEUS were evaluated,and the features of hemangionmas were groups as echoic and compared with those on CEUS.Results All hemangiomas enhanced in arterial phase with centripetal progression in venous and late phase on CEUS,among which 41 lesions showed peripheral nodular enhancement while 8 showed peripheral rim-like enhancement.The whole-tumor enhancement pattern was seen in 13 lesions and part-tumor enhancement was shown in 36 lesions.The performance of part-tumor was independent of tumor echoic and hypoechoic tumors mostly presented to be whole tumor enhancement pattern.During portal venous and late phase,42 lesions showed hyperenhancement,while 7 lesions showed isoenhancement.Conclusions CEUS can suggest the enhancement dynamic characters of hepatic giant hemangionmas and reveals the relationship of grey-scale echoic and enhancement pattern of hemangiomas.It is important to diagnose the hepatic giant hemangionmas for CEUS.%目的 探讨肝巨大血管瘤实时超声造影的具体表现及特征.方法 对手术和病理证实的44例共49个肝巨大血管瘤进行实时超声造影检查,分析不同时相中的动态增强及减退表现与肿瘤回声间的关系.结果 49个肝巨大血管瘤在超声造影时均出现不同程度的增强,其中41个表现为动脉期周边结节状增强,8个表现为动脉期周边环状增强;所有病灶门脉期及延迟期造影剂均呈现向内逐渐填充的增强过程,即向心性增强.13个病灶(26.5％)在门脉期或延迟期呈整体完全填充,36个(73.5％)表现为不完全填充.不完全填充的肝巨大血管瘤的百分率与肿瘤回声无关,而高回声为主的肝巨大血管瘤完全充填者的百分率明显低于以低回声为主者(P＜0.01).门脉期及延迟期呈高回声改变者42个,等回声改变者7个.结论 实时超声造影可以敏感地显示肝巨大血管瘤的动态增强特征,有助于提高超声诊断准确性.