周围型肝内胆管细胞癌的超声造影表现

摘要

目的 探讨周围型肝内胆管细胞癌(intrahepatic peripheral cholangiocarcinoma , ICC)的超声造影表现,提高超声造影对该病的诊断水平.方法 回顾性分析30例术前行超声造影检查、术后经病理证实为ICC患者的超声、临床及病理学资料,分析ICC的超声造影特征及与病理分化程度的关系.结果 超声造影模式下, 30例病灶均可见动脉相造影剂填充,门脉相造影剂减退,超声造影表现为"快进快退"的增强模式.动脉相中,10例病灶呈周边环状高增强, 10例呈较均匀的整体高增强, 6例呈不均匀增强, 2例呈整体等增强,2例呈整体低增强. 30例病灶的超声造影平均增强时间为(18 .81 ± 4 .66) s (12～28 s) ,平均减退时间为(36 .00 ± 12 .30) s (18～60 s) .不同病理分化程度病灶内造影剂增强及减退时间之间差异无统计学意义(均 P ＞0 .05 ) .结论 ICC超声造影表现为"快进快退"的增强模式,且造影剂减退多发生在动脉相晚期或门脉相早期,但不同分化程度的ICC造影剂增强及减退时间之间无明显差异.%Objective To investigate the contrast-enhanced ultrasonography appearances characteristics of intrahepatic peripheral cholangiocarcinoma( ICC) and to improve the diagnosis level of ICC on contrast-enhanced ultrasonography . Methods Thirty cases with ICC confirmed by pathological examinations of surgeries were retrospectively analyzed for findings of ultrasonography , clinic and pathology ,to explore the typical contrast-enhanced ultrasonography appearances and the correlation with pathological differentiation . ResultsOn contrast-enhanced ultrasonography , 30 lesions showed enhancement on the arterial phase and appeared hypo-echoic enhancement on the portal phase ,which displayed fast-in and fast-out" enhancement pattern . During the hepatic arterial phase of contrast-enhanced ultrasonography ,10 lesions showed peripheral enhancement ,10 lesions showed relatively homogeneous hyper-enhancement ,6 lesions showed heterogeneous enhancement ,2 lesions showed iso-enhancement ,and 2 lesions showed hypo-enhancement . To the 30 lesions ,the average initial time of enhancement was ( 18 .81 ± 4 .66)s (12 －28 s) ,the average time of washing-out was (36 .00 ± 12 .30) s (18 －60 s) . There was no significant difference in time of washing-in and washing-out among different pathological differentiation groups ( P＞0 .05) . Conclusions ICC often shows fast-in and fast-out" enhancement pattern on contrast-enhanced ultrasonography ,and the time of washing-out is generally in late arterial phase or early portal phase ,but there is no significant difference in time of washing-in and washing-out among different pathological differentiation groups .