摘要
目的探讨超声造影在胆管细胞癌与早期肝脓肿鉴别诊断中的价值。方法对51例肝内胆管细胞癌患者和30例早期肝脓肿患者分别行彩色多普勒超声和超声造影检查,对比分析两种病灶及其周围组织、相关血管的动态超声造影特征。结果早期肝脓肿患者在彩色多普勒超声下异常灌注区平均面积为(4.27±1.05)cm2,超声造影下为(6.83±1.74)cm2,差异有统计学意义(P=0.03);胆管细胞癌患者在彩色多普勒超声下异常灌注区平均面积为(3.87±2.14)cm2,超声造影检查下为(4.02±1.92)cm2,差异无统计学意义。胆管细胞癌患者超声造影动脉期表现以高增强为主,少部分表现为等增强或低增强;门脉期以低增强或稍低增强为主,少部分表现为等增强;延迟期均表现为低增强;可见典型的快进快出的造影动态模式。22例肝脓肿患者在各个造影时相表现为厚间隔环状强化带,8例表现为网格状等增强,亦可见快进快出的造影动态模式。肝脓肿患者中,肿块内部及周边血管走行正常者27例,紊乱者3例,肝内胆管细胞癌患者中,血管走行正常者27例,紊乱者24例,差异有统计学意义(P﹤0.001)。肝内胆管细胞癌患者中,肿块内部及周边门静脉栓子形成者4例,未形成者47例,肝脓肿患者中,静脉栓子形成者1例,未形成者29例,差异无统计学意义。结论超声造影在胆管细胞癌和早期肝脓肿的鉴别诊断中有重要价值,可临床推广应用。
Objective To assess the clinic value of contrast-enhanced ultrasound （CEUS） in differential diagnosis of cholangiocarcinoma and early stage liver abscess. Methods Fifty-one patients with pathologically verified intrahepatic cholangiocarcinoma and 30 patients with pathologically confirmed early stage liver abscess were included in this study. All patients were investigated using color Doppler flow imaging （CDFI） and CEUS. Characteristics of the dynamic perfusion of lesions and surrounding tissues with contrast agent and color signals were compared. Results The area of abundant perfusion of CEUS （6.83 ± 1.74 ）cm^2 was significantly higher than that of CDFI （4.27 ± 1.05 ）cm^2 in patients with early stage liver abscess （P = 0.03）. No significant difference was found between the abnormal perfusion areas detected from CDFI （3.87 ± 2.14 ）cm^2 and CEUS （4.02 ± 1.92）cm^2 in patients with cholangiocarcinoma. Patients with cholangiocarcinoma ultrasound contrast arterial phase high enhanced,a small part of the performance is enhanced or low enhancements.Portal venous phase to the low enhancement or slightly enhanced, a small part of the performance enhancements such. Delay period showed low enhancement, the typical sign of fast-in-and-fast-washout was found. 22 cases of liver abscess in patients with ring enhancement with thick interval in each angiography, 8 patients showed for the grid-like enhancement, the typical sign of fast-in-and-fast-washout was found. Patients with liver abscess, mass internal and peripheral vascular traveling normal in 27 cases, 3 cases of the disorder,patients with intrahepatic cholangiocarcinoma,blood vessels line normal in 27 cases,24 cases of the disorder,there was significant difference （P〈 0.001）. Patients with intrabepatic cholangiocarcinoma, within the tumor and surrounding portal vein emboli formed in 4 cases, 47 cases was not formed,in patients with liver abscess,venous emboli formed in 1 case,29 cases was not formed,there was no significant differenc
出处
《临床超声医学杂志》
2013年第4期235-237,共3页
Journal of Clinical Ultrasound in Medicine
基金
广东省科技计划项目(2009B060700026)
关键词
超声检查
造影剂
胆管细胞癌
肝脓肿
Ultrasonography
Contrast agent
Cholangiocarcinoma
Liver abscess
