摘要
目的 探讨实时超声造影对肝血管平滑肌脂肪瘤的术前诊断意义.方法 19例入组患者共计21个手术切除病理学确诊的肝血管平滑肌脂肪瘤,5例采用脉冲反向谐波造影技术,14例采用对比脉冲序列造影技术,机械指数＜0.2,2.4 ml造影剂SonoVue团注.将超声造影与增强螺旋CT的术前诊断与手术后病理结果进行比较分析.结果 超声造影15个肿瘤诊断为血管平滑肌脂肪瘤,误诊为肝癌1个、肝腺瘤2个、肝血管瘤1个,2个考虑良性肿瘤但不能进一步分型,超声造影术前诊断准确率为71.4%.增强CT检查8个肿瘤诊断为血管平滑肌脂肪瘤,误诊为肝癌7个、脂肪肉瘤1个、脂肪瘤2个、肝腺瘤1个、血管瘤2个.增强CT的术前诊断准确率为38.1%,低于实时超声造影（P＜0.05）.结论 实时超声造影能够准确反映大多数肝血管平滑肌脂肪瘤的血管分布和血流灌注特点,对肝血管平滑肌脂肪瘤的术前诊断准确率高于增强CT.
Objective To observe the perfusion pattern of hepatic angiomyolipomas using contrastenhanced ultrasound（CEUS） and compare diagnostic efficacy of contrast-enhanced ultrasound with contrastenhanced helical CT（CECT）.Methods Nineteen patients with 21 resected and pathologically proven hepatic angiomyolipomas were included in this study.Low mechanical index （mechanical index less than 0.2） realtime CEUS was performed in nineteen patients （5 patients with pulse inversion harmonic, 14 patients with contrast pulse sequencing, CPS） after 2.4ml bolus injection of contrast agent SonoVue.CECT was performed using 16-slice helical CT and contrast agent Ultravist.The diagnostic performance was calculated by considering histologic results as the reference standards.Results Fifteen tumors were correctly diagnosed as hepatic angiomyolipomas,4 tumors were misdiagnosed （including 1 hepatocellular carcinoma,2hepatic adenomas, 1 hemangioma） and 2 tumors were characterized as benign lesions by CEUS.Eight tumors were correctly diagnosed as hepatic angiomyolipomas, 13 tumors were misdiagnosed （including 7hepatocellular carcinoma, 1 liposarcoma, 2 lipomas, 1 hepatic adenomas, 2 hemangiomas） by CECT.The preoperative diagnostic accuracy was 71.4% for CEUS and 38.1 % for CECT（P〈0.05 ）.Conclusions CEUS can demonstrate typical imaging characteristics of most hepatic angiomyolipomas, and has higher diagnostic performance than CECT in characterization of hepatic angiomyotipomas.
出处
《中华超声影像学杂志》
CSCD
北大核心
2010年第6期485-488,共4页
Chinese Journal of Ultrasonography
