实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (4): 601-604.doi: 10.3969/j.issn.1672-5069.2026.04.031

• 肝脓肿 • 上一篇    下一篇

超声造影辅助早期诊治细菌性肝脓肿应用价值研究*

王冠华, 王萍, 杨金君, 郭娟妮   

  1. 712000 陕西省咸阳市 陕西中医药大学附属咸阳市第一人民医院超声医学科
  • 收稿日期:2025-10-15 出版日期:2026-07-10 发布日期:2026-07-20
  • 通讯作者: 郭娟妮,E-mail:729765187@qq.com
  • 作者简介:王冠华,男,35岁,大学本科,主治医师。E-mail:18681997891@163.com
  • 基金资助:
    *陕西省咸阳市科技局重点研发计划项目(编号:2021ZDYF-SF-0058)

Application of contrast-enhanced ultrasound in the diagnosis and treatment of patients with early bacterial liver abscess

Wang Guanhua, Wang Ping, Yang Jinjun, et al   

  1. Department of Ultrasound, First People's Hospital, Affiliated to Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, Shaanxi Province, China
  • Received:2025-10-15 Online:2026-07-10 Published:2026-07-20

摘要: 目的 探讨超声造影(CEUS)辅助早期诊断细菌性肝脓肿(BLA)的临床应用价值。方法 2022年5月~2024年12月我院收治的113例疑似早期BLA患者,均行常规超声和CEUS检查,根据CEUS增强模式将LA分为Ⅰ型(液化型)和Ⅱ型(实变型)。给予穿刺引流和抗生素应用治疗。结果 在113例疑似患者中,经临床综合判断,最终确诊为早期BLA者98例(86.7%),肝细胞癌7例,肝脏转移癌5例和肝血管瘤3例;在98例临床确诊为早期BLA的患者中,82例(83.7%)属于Ⅰ型,接受了US引导下经皮穿刺引流联合抗生素治疗,另16例(16.3%)为Ⅱ型,仅接受抗生素治疗。所有Ⅰ型患者初始治疗有效率为100.0%,14例(87.5%)Ⅱ型患者初始治疗效果良好,仅2例在治疗一周后复查发现病灶液化,经转为穿刺引流治疗后亦获痊愈;在疗效监测方面,CEUS评估显示出判断疗效早于临床表现和实验室检查指标,治疗后第3天即显示有效76例(77.6%),而此时体温和白细胞计数恢复正常的患者仅分别为42例(42.9%)和38例(38.8%)。结论 采用CEUS检查可显著提高对BLA的早期诊断准确性,并在疗效监测方面也显示出优势,其应用价值还有待探讨。

关键词: 细菌性肝脓肿, 超声造影, 诊断, 疗效监测

Abstract: Objective The aim of this study was to explore the application of contrast-enhanced ultrasound (CEUS) in the diagnosis and treatment of patients with early bacterial liver abscess (BLA). Methods A total of 113 patients with suspected liver abscess were admitted to our hospital between May 2022 and December 2024, and all underwent routine ultrasonography and CEUS examinations. The abscess tying was performed based on CEUS enhancement model as type I, e.g., liquefaction, and type II, e.g., consolidation. The surveillance of abscess changes by CEUS was also performed. Results Of the 113 patients with suspected intrahepatic occupying lesions, comprehensive clinical materials confirmed BLA in 98 cases (86.7%), hepatocellular carcinoma in 7 cases, liver metastases in 5 cases and hepatic hemangioma in 3 cases; of the 98 patients with early BLA, CEUS found type I in 82 cases (83.7%), and type II in 16 cases (16.3%); all patients with type I recovered (100.0% effective) after puncture drainage and intravenous antibiotics tretament, and patients with type II patients responded well in 14 cases (87.5%), and abscess liquefied 1 week after in 2 cases, switched to puncture drainage and recovered; as for surveillance of therapeutic efficacy, CEUS showed a satisfactory priority, as it found effective earlier than clinical manifestations and/OR laboratory indexes. 3 days after treatment, there were 76 cases (77.6%) with reduction of abscess, while only 42 cases (42.9%) and 38 cases (38.8%) presented with normal body temperature and white blood cell count normal, at that time. Conclusion CEUS could help diagnose BLA early, and it also could help clinicians monitor the therapeutic process, and the clinical application needs further verification.

Key words: Bacterial liver abscess, Contrast-enhanced ultrasound, Diagnosis, Surveillance