超声造影在判断肝脏局灶性结节性质中的应用价值
摘要
肝脏局灶性结节种类繁多、病理结构复杂多样,对其性质的准确诊断有助于临床选择合适的治疗方法。超声造影作为一种新型血池造影技术,通过病灶在动脉期、门脉期及延迟期的增强强度与周围正常肝组织进行对比(低增强、等增强、高增强)、开始增强的部位(外周、中心)以及特定的灌注方式(轮辐状增强、结节状增强、弥漫性增强)来对病灶的性质进行综合判断。性质不同的肝脏局灶性结节超声造影灌注特点不同,以此对结节性质作出准确诊断。
引文
[1]宋毅.实时剪切波弹性成像与超声造影在肝脏局灶性病变中的应用价值[D].郑州大学,2015.
[2]任卫东,常才.超声诊断学[M].北京:人民卫生出版社,2016:524.
[3]杨洁,张学兰.超声造影与声辐射力脉冲成像技术在肝脏占位性病变鉴别诊断中的应用价值[J].中国超声医学杂志,2015,31(6):518-520.
[4]张茜,陈文卫,夏洪波,等.动态血管模式在低回声肝血管瘤与原发性肝癌鉴别诊断中的价值[J].武汉大学学报(医学版),2016,37(2):277-281,287.
[5]Yamashita Y,Ogata I,Urata J,et al.Cavenous hemangioma of the liver:pathologic correlation with dynamic CT findings[J].Radiology,1997,203(1):121-125.
[6]王文平,丁红,黄备建,等.阻力指数在肝肿瘤超声诊断中的价值[J].中华超声影像学杂志,2002,11(11):658-660.
[7]Gaiani S,Casali A,Serra C,et al.Assessment of vascular patterns of small liver mass lesions:value and limitation of the different Doppler ultrasound modalities[J].Am J Gastroenterol,2000,95(12):3537-3546.
[8]Ding H,Wang WP,Huang BJ,et al.Imaging of focal liver lesions:low-mechanical-index real-time ultrasonography with SonoVue[J].J Ultrasound Med,2005,24(3):285-297.
[9]Leen E,Angerson WJ,Yarmenitis S,et al.Multi-centre clinical study evaluating the efficacy of SonoVue(BR1),a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions[J].Eur J Radiol,2002,41(3):200-206.
[10]戴莹,陈敏华,严昆,等.超声造影对不典型肝血管瘤的增强模式探讨[J].中华超声影像学杂志,2005,14(7):512-516.
[11]Dietrich CF,Mertens JC,Braden B,et al.Contrast-enhanced ultrasound of histologically proven liver hemangiomas[J].Hepatology,2007,45(5):1139-1145.
[12]朱旭娜,苏丹柯,刘丽东,等.增强CT定量分析在肝细胞肝癌和局灶性结节增生鉴别诊断中的价值研究[J].临床放射学杂志,2018,37(6):976-979.
[13]Nguyen BN,Fléjou JF,Terris B,et al.Focal nodular hyperplasia of the liver:a comprehensive pathologic study of 305 lesions and recognition of new histologic forms[J].Am J Surg Pathol,1999,23(12):1441-1454.
[14]Roche V,Pigneur F,Tselikas L,et al.Differentiation of focal nodular hyperplasia from hepatocellular adenomas with lowmechanical-index contrast-enhanced sonography(CEUS):effect of size on diagnostic confidence[J].Eur Radiol,2015,25(1):186-195.
[15]Kong WT,Wang WP,Huang BJ,et al.Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma[J].Ultrasound Med Biol,2015,41(4):944-951.
[16]Njoku VC,Howard TJ,Shen C,et al.Pyogenic liver abscess following pancreatic oduodenectomy:risk factor,treatment and long-term outcome[J].J Gastrointest Surg,2014,18(5):922-928.
[17]Sachdev DD,Yin MT,Horowitz JD,et al.Klebsiella pneumoniae K1 liver abscess and septic endophthalmitis in a U.S.resident[J].J Clin Microbiol,2013,51(3):1049-1051.
[18]马思思,陈利民,贺军,等.肝脓肿患者超声造影诊断的分析[J].中华医院感染学杂志,2016,26(10):2293-2295.
[19]Lee CH,Chuah SK,Tai WC,et al.Platelet reactivity in diabetic patients with invasive Klebsiella pneumoniae liver abscess syndrome[J].Infect Drug Resist,2018,11:1669-1676.
[20]卜岚,聂芳,刘婷,等.超声造影在不典型肝脓肿鉴别诊断中的意义[J].中国临床医学影像杂志,2015,26(4):264-266,270.
[21]郭晶晶,王慧珠,李娟,等.39例细菌性肝脓肿患者的病原学分布及耐药性分析[J].中华实验和临床感染病杂志(电子版),2015,9(1):69-72.
[22]Dietrich CF,Jenssen C.Focal liver lesion,incidental finding[J].Dtsch Med Wochenschr,2012,137(41):2099-2116.
[23]Dietrich CF.Comments and illustrations regarding the guidelines and good clinical practice recommendations for contrast-enhanced ultrasound(CEUS)--update 2008[J].Ultraschall Med,2008,29(Suppl 4):S188-202.
[24]Dietrich CF.Liver tumor characterization--comments and illustrations regarding guidelines[J].Ultraschall Med,2012,33(Suppl 1):S22-30.
[25]Dietrich CF,Cui XW,Schreiber-Dietrich DG,et al.EFSUMBguidelines 2011:comments and illustrations[J].Ultraschall Med,2012,33(Suppl 1):S11-21.
[26]孙秀丽.超声造影检查对肝脓肿的诊断价值[J].现代消化及介入诊疗,2017,22(3):410-412.
[27]邹涛,陆敏姣,管建明,等.超声造影诊断肝脓肿感染的临床研究[J].中华医院感染学杂志,2018,28(24):3792-3795.
[28]Gabata T,Kadoya M,Matsui O,et al.Dynamic CT of hepatic abscesses:significance of transient segmental enhancement[J].AJR Am J Roentgenol,2001,176(3):675-679.
[29]Mathieu D,Vasile N,Fagniez PL,et al.Dynamic CT features of hepatic abscesses[J].Radiology,1985,154(3):749-752.
[30]Viamonte M,Soen S,Lapage J.Nonspecificity of abnormal vascularity in the angiographic diagnosis of malignant neoplasms[J].Radiology,1973,106(1):59-62.
[31]Gammil SL,Shipkey RB,Himmelfarb EH,et al.Roent Genologypathology correlative study of neovascularity[J].AJR Am JRoentgenol,1976,126(2):376-385.
[32]程文,余晓梅.超声造影评估肝细胞性肝癌分化程度[J].医学信息,2013,26(5中):282.
[33]Kitao A,Zen Y,Matsui O,et al.Hepatocarcinogenesis:multistep changes of drainage vessels at CT during arterial portography and hepatic arteriography--radiologic-pathologic correlation[J].Radiology,2009,252(2):605-614.
[34]张民,周晓东,任小龙,等.实时超声造影在原发性肝癌鉴别诊断中的应用研究[J].中华超声影像学杂志,2006,15(6):428-430.
[35]唐小乔,仇毓东,张炜炜,等.超声及增强CT在肝内胆管细胞癌诊断中的应用[J].肝胆外科杂志,2010,18(5):335-337,361.
[36]吴莉莉,苏中振,吴涛,等.胆管细胞癌超声造影与增强CT/MRI诊断价值的比较[J].中华肝胆外科杂志,2012,18(11):871-872.
[37]毛枫,李超伦,黄备建,等.肝内胆管细胞癌超声造影表现[J].中华医学超声杂志(电子版),2013,10(5):364-367
[38]吕珂,姜玉新,戴晴,等.超声造影对肝内胆管细胞癌的诊断价值[J].中国医学影像技术,2005,21(8):1239-1241.
[39]Curley SA,Izzo F,Delrio P,et al.Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies:results in 123 patients[J].Ann Surg,1999,230(1):1-8.
[40]Gayowski TJ,Iwatsuki S,Madariaga JR,et al.Experience in hepatic resection for metastatic colorectal cancer:analysis of clinical and pathologic risk factors[J].Surgery,1994,116(4):703-710;discussion 710-7111.
[41]滕瑞军,陈虎,黄儒飞.血清总胆汁酸测定在肝病诊断中的价值分析[J].转化医学电子杂志,2015,2(3):113-114.
[42]Yue WW,Wang S,Xu HX,et al.Parametric imaging with contrast-enhanced ultrasound for differentiating hepatocellular carcinoma from metastatic liver cancer[J].Clin Hemorheol Microcirc,2016,64(2):177-188.
[43]司芩,钱晓莉,黄声稀,等.原发性肝癌超声造影特征及其与病理相关性的研究[J].临床肿瘤学杂志,2011,16(1):50-53.
[44]Liu Y,Matsui O.Changes of intratumoral microvessels and blood perfusion during establishment of hepatic metastases in mice[J].Radiology,2007,243(2):386-395.
[45]李智岗,黄景香,李顺宗,等.肝转移的血供[J].北京大学学报,2008,40(2):146-150.
[46]Numata K,Tanaka K,Kiba T,et al.Contrast-enhanced,wideband harmonic gray scal imaging of hepatocellular carcinoma:correlation with helical computed tomographic findings[J].JUltrasound Med,2001,20(2):89-98.
[47]Strobel D,Krodel U,Martus P,et al.Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors[J].J Clin Ultrasound,2000,28(1):1-13.
[48]梁丽,张建蕾,宋妮.AFP阳性与阴性肝癌患者的超声造影定量分析参数比较[J].现代消化及介入诊疗,2019,24(1):71-73.
[2]任卫东,常才.超声诊断学[M].北京:人民卫生出版社,2016:524.
[3]杨洁,张学兰.超声造影与声辐射力脉冲成像技术在肝脏占位性病变鉴别诊断中的应用价值[J].中国超声医学杂志,2015,31(6):518-520.
[4]张茜,陈文卫,夏洪波,等.动态血管模式在低回声肝血管瘤与原发性肝癌鉴别诊断中的价值[J].武汉大学学报(医学版),2016,37(2):277-281,287.
[5]Yamashita Y,Ogata I,Urata J,et al.Cavenous hemangioma of the liver:pathologic correlation with dynamic CT findings[J].Radiology,1997,203(1):121-125.
[6]王文平,丁红,黄备建,等.阻力指数在肝肿瘤超声诊断中的价值[J].中华超声影像学杂志,2002,11(11):658-660.
[7]Gaiani S,Casali A,Serra C,et al.Assessment of vascular patterns of small liver mass lesions:value and limitation of the different Doppler ultrasound modalities[J].Am J Gastroenterol,2000,95(12):3537-3546.
[8]Ding H,Wang WP,Huang BJ,et al.Imaging of focal liver lesions:low-mechanical-index real-time ultrasonography with SonoVue[J].J Ultrasound Med,2005,24(3):285-297.
[9]Leen E,Angerson WJ,Yarmenitis S,et al.Multi-centre clinical study evaluating the efficacy of SonoVue(BR1),a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions[J].Eur J Radiol,2002,41(3):200-206.
[10]戴莹,陈敏华,严昆,等.超声造影对不典型肝血管瘤的增强模式探讨[J].中华超声影像学杂志,2005,14(7):512-516.
[11]Dietrich CF,Mertens JC,Braden B,et al.Contrast-enhanced ultrasound of histologically proven liver hemangiomas[J].Hepatology,2007,45(5):1139-1145.
[12]朱旭娜,苏丹柯,刘丽东,等.增强CT定量分析在肝细胞肝癌和局灶性结节增生鉴别诊断中的价值研究[J].临床放射学杂志,2018,37(6):976-979.
[13]Nguyen BN,Fléjou JF,Terris B,et al.Focal nodular hyperplasia of the liver:a comprehensive pathologic study of 305 lesions and recognition of new histologic forms[J].Am J Surg Pathol,1999,23(12):1441-1454.
[14]Roche V,Pigneur F,Tselikas L,et al.Differentiation of focal nodular hyperplasia from hepatocellular adenomas with lowmechanical-index contrast-enhanced sonography(CEUS):effect of size on diagnostic confidence[J].Eur Radiol,2015,25(1):186-195.
[15]Kong WT,Wang WP,Huang BJ,et al.Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma[J].Ultrasound Med Biol,2015,41(4):944-951.
[16]Njoku VC,Howard TJ,Shen C,et al.Pyogenic liver abscess following pancreatic oduodenectomy:risk factor,treatment and long-term outcome[J].J Gastrointest Surg,2014,18(5):922-928.
[17]Sachdev DD,Yin MT,Horowitz JD,et al.Klebsiella pneumoniae K1 liver abscess and septic endophthalmitis in a U.S.resident[J].J Clin Microbiol,2013,51(3):1049-1051.
[18]马思思,陈利民,贺军,等.肝脓肿患者超声造影诊断的分析[J].中华医院感染学杂志,2016,26(10):2293-2295.
[19]Lee CH,Chuah SK,Tai WC,et al.Platelet reactivity in diabetic patients with invasive Klebsiella pneumoniae liver abscess syndrome[J].Infect Drug Resist,2018,11:1669-1676.
[20]卜岚,聂芳,刘婷,等.超声造影在不典型肝脓肿鉴别诊断中的意义[J].中国临床医学影像杂志,2015,26(4):264-266,270.
[21]郭晶晶,王慧珠,李娟,等.39例细菌性肝脓肿患者的病原学分布及耐药性分析[J].中华实验和临床感染病杂志(电子版),2015,9(1):69-72.
[22]Dietrich CF,Jenssen C.Focal liver lesion,incidental finding[J].Dtsch Med Wochenschr,2012,137(41):2099-2116.
[23]Dietrich CF.Comments and illustrations regarding the guidelines and good clinical practice recommendations for contrast-enhanced ultrasound(CEUS)--update 2008[J].Ultraschall Med,2008,29(Suppl 4):S188-202.
[24]Dietrich CF.Liver tumor characterization--comments and illustrations regarding guidelines[J].Ultraschall Med,2012,33(Suppl 1):S22-30.
[25]Dietrich CF,Cui XW,Schreiber-Dietrich DG,et al.EFSUMBguidelines 2011:comments and illustrations[J].Ultraschall Med,2012,33(Suppl 1):S11-21.
[26]孙秀丽.超声造影检查对肝脓肿的诊断价值[J].现代消化及介入诊疗,2017,22(3):410-412.
[27]邹涛,陆敏姣,管建明,等.超声造影诊断肝脓肿感染的临床研究[J].中华医院感染学杂志,2018,28(24):3792-3795.
[28]Gabata T,Kadoya M,Matsui O,et al.Dynamic CT of hepatic abscesses:significance of transient segmental enhancement[J].AJR Am J Roentgenol,2001,176(3):675-679.
[29]Mathieu D,Vasile N,Fagniez PL,et al.Dynamic CT features of hepatic abscesses[J].Radiology,1985,154(3):749-752.
[30]Viamonte M,Soen S,Lapage J.Nonspecificity of abnormal vascularity in the angiographic diagnosis of malignant neoplasms[J].Radiology,1973,106(1):59-62.
[31]Gammil SL,Shipkey RB,Himmelfarb EH,et al.Roent Genologypathology correlative study of neovascularity[J].AJR Am JRoentgenol,1976,126(2):376-385.
[32]程文,余晓梅.超声造影评估肝细胞性肝癌分化程度[J].医学信息,2013,26(5中):282.
[33]Kitao A,Zen Y,Matsui O,et al.Hepatocarcinogenesis:multistep changes of drainage vessels at CT during arterial portography and hepatic arteriography--radiologic-pathologic correlation[J].Radiology,2009,252(2):605-614.
[34]张民,周晓东,任小龙,等.实时超声造影在原发性肝癌鉴别诊断中的应用研究[J].中华超声影像学杂志,2006,15(6):428-430.
[35]唐小乔,仇毓东,张炜炜,等.超声及增强CT在肝内胆管细胞癌诊断中的应用[J].肝胆外科杂志,2010,18(5):335-337,361.
[36]吴莉莉,苏中振,吴涛,等.胆管细胞癌超声造影与增强CT/MRI诊断价值的比较[J].中华肝胆外科杂志,2012,18(11):871-872.
[37]毛枫,李超伦,黄备建,等.肝内胆管细胞癌超声造影表现[J].中华医学超声杂志(电子版),2013,10(5):364-367
[38]吕珂,姜玉新,戴晴,等.超声造影对肝内胆管细胞癌的诊断价值[J].中国医学影像技术,2005,21(8):1239-1241.
[39]Curley SA,Izzo F,Delrio P,et al.Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies:results in 123 patients[J].Ann Surg,1999,230(1):1-8.
[40]Gayowski TJ,Iwatsuki S,Madariaga JR,et al.Experience in hepatic resection for metastatic colorectal cancer:analysis of clinical and pathologic risk factors[J].Surgery,1994,116(4):703-710;discussion 710-7111.
[41]滕瑞军,陈虎,黄儒飞.血清总胆汁酸测定在肝病诊断中的价值分析[J].转化医学电子杂志,2015,2(3):113-114.
[42]Yue WW,Wang S,Xu HX,et al.Parametric imaging with contrast-enhanced ultrasound for differentiating hepatocellular carcinoma from metastatic liver cancer[J].Clin Hemorheol Microcirc,2016,64(2):177-188.
[43]司芩,钱晓莉,黄声稀,等.原发性肝癌超声造影特征及其与病理相关性的研究[J].临床肿瘤学杂志,2011,16(1):50-53.
[44]Liu Y,Matsui O.Changes of intratumoral microvessels and blood perfusion during establishment of hepatic metastases in mice[J].Radiology,2007,243(2):386-395.
[45]李智岗,黄景香,李顺宗,等.肝转移的血供[J].北京大学学报,2008,40(2):146-150.
[46]Numata K,Tanaka K,Kiba T,et al.Contrast-enhanced,wideband harmonic gray scal imaging of hepatocellular carcinoma:correlation with helical computed tomographic findings[J].JUltrasound Med,2001,20(2):89-98.
[47]Strobel D,Krodel U,Martus P,et al.Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors[J].J Clin Ultrasound,2000,28(1):1-13.
[48]梁丽,张建蕾,宋妮.AFP阳性与阴性肝癌患者的超声造影定量分析参数比较[J].现代消化及介入诊疗,2019,24(1):71-73.