肝脏炎性假瘤的多普勒超声和灰阶超声诊断

摘要

本文通过肝脏炎性假瘤(IPL)的B超、彩色多普勒(CD)和脉冲多普(PD)的表现,探讨 它们对IPL的诊断价值.本组病例共10例,12个病灶,最大4cm,最小0.8cm.检查时先用B超显示,后用CD检测血流,如有血流,则用PD检测流速及阻力指数(RI).结果显示IPL在B超上均表现为低回声欠均质光团,个别有晕圈样表现,B超容易误诊,本组符合率仅为25%.进一步分析发现IPL在B超上可有形态不规则多呈哑铃状或葫芦状表现,实时下可有延伸感,并且后方无增强改变,这些对诊断IPL有帮助.在9个经CD和PD检查的IPL中,6个未见彩色血流,3个周边有彩色血流并且测及动脉频谱,其中2个RI<0.5.这些表现均与病理显示相吻合.而多普勒诊断IPL为良性病变的符合率为89%(8/9),与B超结合诊断为IPL的符合率为56%(5/9),显著高于单纯B超检查.因此,多普勒结合B超对IPL,的诊断有很大帮助.%Ten patients with 12 inflammatory pseudotumor of the liver (IPL) lesions were routinely examined by gray scale uhrasonography(B-US),color Doppler (CD)and pulscd Doppler(PD). All of them in B-US were hypoechoic pattern with inhomogeneity,and one of them displayed helo-like,margin, suggesting malignant tumor. However, the irregular shape with calabash-like was found in 10 IPL lesions by B-US, being different from liver cancer.The color blood flow and arterial spectrum were detected by CD and PD in the margin 3 of 9 IPL lesions,and the resistant index was less than 0.5 in 2 of 3 IPL with Doppler signals, 6 of them were suggested to lack of blood supply, the manifistations of Doppler were consistent with pathology of IPL. Therefore, 8 lesions were considered to be benign lesions by Doppler US and the accuracy for the diagnosis of IPL was 56%(5/9)by using Doppler combined with B-US.