肝腺瘤超声造影和增强CT的对比分析
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摘要
目的:探讨肝腺瘤(HCA)的超声造影(CEUS)和增强CT(CECT)的表现,并对两者进行对比分析。方法:回顾性分析10例经病理证实的HCA超声造影表现,其中8例行CT扫描,并对具有CEUS和CECT检查的HCA进行对比分析。结果:10例均为单发肿块,大小约1.4～20cm。超声检查7个病灶为低回声,2个病灶为高回声,1个病灶为等回声。CT平扫7个病灶为低密度,1个病灶为高密度。在CEUS和CECT中,动脉期所有病例均表现为高增强,门静脉期4例CEUS、4例CECT表现为低增强,延迟期7例CEUS、4例CECT表现为低增强。CEUS中有8例动脉期观察到向心性增强,三期观察到持续性的边缘血管环状增强,5例在门脉期或延迟期观察到中央性消退,1例观察到中央非增强区。增强CT中3例表现为中央非增强性坏死区,3例表现为肿瘤内血管影,2例表现为肿瘤包膜增强。结论:与CECT相比,CEUS在诊断HCA更具有特征性,CEUS表现为向心性增强,持续性的边缘血管环状增强,肿块中央性消退均具有特征性。
Objective:To explore and compare the performance of contrast-enhanced ultrasound(CEUS) and contrast-enhanced CT(CECT) in hepatic adenomas.Methods:Ten cases of pathologically confirmed HCA contrast-enhanced ultrasonography were retrospectively analyzed. Eight of them underwent CT scan, and the results of those with CEUS and CECT were compared.Results:All 10 cases were single-shot masses with a size of 1.4 to 20 cm. Ultrasound examination showed that 7 lesions were hypoechoic, 2 were hyperechoic, and 1 was iso-echo. CT scan showed that, 7 lesions were with low density and 1 lesion with high density. By CEUS and CECT, all cases showed high enhancement in the arterial phase, 4 cases by CEUS and 4 cases by CECT showed low enhancement in the portal vein, 7 cases by CEUS and 4 cases by CECT showed low enhancement in the delay phase. In CEUS, 8 cases showed centripetal enhancement in the arterial phase, continuous marginal vascular ring enhancement was observed in the third stage, central remission was observed in 5 cases in the portal or delay phase, and central non-enhancement was observed in 1 case. In the contrast-enhanced CT, 3 cases showed central non-enhanced necrosis, 3 cases showed intratumoral vascular shadow, and 2 cases showed tumor capsule enhancement.Conclusion:Compared with CECT, CEUS is with more distinct features in the diagnosis of HCA. CEUS is characterized by increased centripetality, persistent marginal vascular ring enhancement, and central remission of the mass.
Objective:To explore and compare the performance of contrast-enhanced ultrasound(CEUS) and contrast-enhanced CT(CECT) in hepatic adenomas.Methods:Ten cases of pathologically confirmed HCA contrast-enhanced ultrasonography were retrospectively analyzed. Eight of them underwent CT scan, and the results of those with CEUS and CECT were compared.Results:All 10 cases were single-shot masses with a size of 1.4 to 20 cm. Ultrasound examination showed that 7 lesions were hypoechoic, 2 were hyperechoic, and 1 was iso-echo. CT scan showed that, 7 lesions were with low density and 1 lesion with high density. By CEUS and CECT, all cases showed high enhancement in the arterial phase, 4 cases by CEUS and 4 cases by CECT showed low enhancement in the portal vein, 7 cases by CEUS and 4 cases by CECT showed low enhancement in the delay phase. In CEUS, 8 cases showed centripetal enhancement in the arterial phase, continuous marginal vascular ring enhancement was observed in the third stage, central remission was observed in 5 cases in the portal or delay phase, and central non-enhancement was observed in 1 case. In the contrast-enhanced CT, 3 cases showed central non-enhanced necrosis, 3 cases showed intratumoral vascular shadow, and 2 cases showed tumor capsule enhancement.Conclusion:Compared with CECT, CEUS is with more distinct features in the diagnosis of HCA. CEUS is characterized by increased centripetality, persistent marginal vascular ring enhancement, and central remission of the mass.
引文
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2 单艳,徐晨,林曦,等.肝细胞癌中心瘢痕MRI特征与病理的对照分析[J].中华放射学杂志,2018,52(4):313-315.
3 刘晗,周显礼,王海健,等.超声弹性成像在肝占位性病变中的应用进展[ J ] .中国医师进修杂志,2014,37(2):73-75.
4 黄燕琪,马泽兰,何兰,等.基于CT图像的纹理分析鉴别肝脏实性局灶性病变[J].中国医学影像学杂志,2016,24(4):289-292.
5 卢薇薇.肝脏良恶性肿瘤高回声局灶性病变的超声造影分析[J].中国医药指南,2016,14 (20) :20-20.
6 Kim G Y,Lee Y M,Kwon J H,et al.Glycogen storage disease type Ia mice with less than 2% of normal hepatic glucose-6-phosphatase-α activity restored are at risk of developing hepatic tumors[J].Molecular Genetics & Metabolism,2017,120(3):229-234.
7 姜川.肝脏良性占位性病变误诊为肝癌分析[J].实用肿瘤杂志,2010,25(4):457-458.
8 张宏春,耿喆.增强CT扫描与超声造影对肝脏占位性病变的临床诊断价值比较[J].实用肝脏病杂志,2016,19(6):696-699.
9 李丹丹,黄进,李文伦,等.超声引导多点扇形立体定位单极冷循环射频消融治疗肝癌[J].中国医学影像技术,2009,25(12):2282-2285.
10 梁英魁,川玲,赵文锐,等.介入治疗后AFP升高的肝癌患者18F-FDG PET/CT显像与增强CT的对比[J].中国介入影像与治疗学,2010,07(5):515-519.