肝脏上皮样血管平滑肌脂肪瘤实时超声造影征象研究

doi:10.3969/j.issn.1672-5069.2020.06.035

摘要/Abstract

摘要： 目的分析总结肝脏上皮样血管平滑肌脂肪瘤(EAML)的灰阶超声、多普勒超声(CDFI)和超声造影(CEUS)表现。方法回顾性分析我院经手术后组织病理学检查证实的20个EAML患者的临床、灰阶超声、CDFI和CEUS资料。结果 20例病灶均为单发,最大径为(49.23±10.3)mm;病灶内部回声为低回声14例(70.0%),高回声3例(15.0%),高低混合不均匀回声3例(15.0%);CDFI显示0级4例(20.0%),I级3例(15.0%),II级10例(50.0%),III级3例(15.0%);阻力指数(RI)为0.46±0.34;CEUS显示所有病灶动脉期都表现为快速高增强,其中13例(86.6%)为整体均匀增强,门静脉期高增强12例(80.0%),等增强2例(13.3%),低增强1例(6.6%),延迟期仍表现为高增强10例(66.6%),等增强4例(26.6%),低增强1例(6.6%)。结论 EAML灰阶超声主要表现为低回声,CDFI显示为富血供、低阻力型血流,CEUS主要表现为快进慢退/不退,三者结合或有助于提高诊断的准确性。

关键词: 肝脏上皮样血管平滑肌脂肪瘤, 多普勒超声, 超声造影, 特征

Abstract: Objective The purpose of this study was to investigate the gray-scale ultrasound(GSUS), Doppler US (CDFI) and contrast-enhanced ultrasound (CEUS) feature of hepatic epithelioid angiomyolipoma (EAML). Methods A retrospective analysis of 20patients with EAML proven by histopathological examination in our hospital was conducted. The clinical data, GSUS, CDFI, and CEUS werereviewed. Results All the 20 cases had a single hepatic lesion, with maximum tumor diameter of (49.23±10.3) mm; the GSUS showed 70.0% (14/20) of lesions were hypo-echoic,15.0% (3/20) hyper-echoic and 15.0% (3/20) mixed-echoic; 50.0% (10/20)of the lesions had striated or branching blood flow and 15.0%(3/20)showed ring-like or arc arterials on Doppler US; the resistance index (RI) was 0.46±0.34; all lesions showed hyperenhancement during arterial phase on CEUS, and 13 cases(86.6%)presenting uniform enhancement; there were 12 cases with high enhancement (80.0%), 2 cases (13.0%) withiso-enhancement and 1 cases(6.6%)with low enhancement in the portal vein phase; in the delayed period, 10 cases (66.6%) had high enhancement, 4 cases (26.6%) had iso-enhancement, and 1 cases (6.6%) had low enhancement. Conclusion The EAML ismainly characterized by hypoechoic, abundant blood flow with low RI, and hyperenhancement in arterial phase and hyper- or iso-enhancement in the portal phase.The combination of GSUS, CDFI and CEUS might improve the correct diagnosis of EAML in clinical practice.

Key words: Epithelioid angiomyolipoma, Doppler ultrasound, Contrast-enhanced Ultrasonography, Feature

谢蠡, 何年安, 叶显俊, 章生龙, 刘力, 胡蕾. 肝脏上皮样血管平滑肌脂肪瘤实时超声造影征象研究[J]. 实用肝脏病杂志, 2020, 23(6): 897-900.

Xie Li, He Nian'an, Ye Xianjun, et al. Imaging feature of epithelioid angiomyolipomas on real-time contrast-enhanced ultrasonography[J]. Journal of Practical Hepatology, 2020, 23(6): 897-900.

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