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超声造影在泡型肝包虫病与肝血管瘤鉴别诊断中的价值
万敏,蔡迪明,李永忠,王文涛,姜勇,滕怀霞,张琼,苟泽辉
0
(四川大学华西医院超声科;四川大学华西医院肝外科;四川大学华西医院病理科)
摘要:
目的 探讨超声造影对泡型肝包虫病(HAE)与肝血管瘤 (HHE)的鉴别诊断价值。方法 纳入2010 年 1 月~2019 年 4 月我院收治的HAE 及 HHE 患者共102例,其中 HHE 患者57例,HAE 患者 45 例。患者均行超声造影检查,分析、比较 HHE 及 HAE 的超声造影特征,包括病灶的位置、数目、大小、内部回声、边界、形态、血流、造影时增强模式等。 结果 两组患者年龄差异及性别构成差异无统计学意义(P>0.05)。57 例 HHE 患者共有 61 个病灶,病变平均大小为(6.5±3.9)cm。45例 HAE 患者共有 57 个病灶,病变平均大小为(8.7±4.9)cm,两组病灶大小的差异有统计学意义(P<0.05),两组病灶内部回声构成、病灶血流差异均无统计学意义(P>0.05);两组病灶的位置、边界、形态差异有统计学意义(P<0.05)。超声造影对泡型肝包虫病和肝血管瘤的检出率高于常规超声, 且差异有统计学意义(P<0.05)。两组患者在动脉期周边增强及病灶内部增强间的差异均有统计学意义(P<0.05)。结论 HAE及HHE的常规超声表现有部分相似,但超声造影表现有明显差异。常规超声结合超声造影可以帮助对HAE与HHE的鉴别。
关键词:  超声造影  泡型肝包虫病  肝血管瘤  鉴别诊断
DOI:
基金项目:四川省财政厅包虫病防治项目(2015ZX01)
The value of contrast enhanced ultrasonography in the differential diagnosis of hepatic hydatidosis and hemangioma
WAN Min,CAI Diming,LI Yongzhong,WANG Wentao,JIANG Yong,TENG Huaixia,ZHANG Qiong,GOU Zehui
(Department of Ultrasound, West China Hospital, Sichuan University;Liver Surgery, West China Hospital, Sichuan University;Department of Pathology, West China Hospital, Sichuan Univeeersity)
Abstract:
Objective To determine the value of contrastenhanced ultrasound (CEUS) in the differentiation of hepatic hemangioma (HHE) and hepatic alveolar echinococcosis (HAE). Methods The data of 102 patients with HHE or HAE were collected between January 2010 and April 2019. Grayscale and CEUS features of the patients were analyzed. The frequency of each imaging finding, including location, number, size, internal echo, boundary, morphology, blood flow, arterial enhancement, and internal enhancement were evaluated and compared.Results There was no significant difference in age and gender composition between the two groups (P>0.05). 61 HHE lesions were detected in 57 patients. The diameters of HHE lesions were 0720cm with an average of (6.5±3.9) cm. 57 HAE lesions were found in 45 patients. The diameters of HAE lesions were 1320 cm with an average of (8.7±4.9) cm. The difference in lesion size between the two groups was statistically significant (P<0.05). There were no statistically significant differences in lesion internal echo composition, and the blood flow between the two groups (P>0.05). There were statistically significant differences in lesion location, boundary and morphology between the two groups (P<0.05). Contrastenhanced ultrasonography had a higher detection rate than conventional ultrasonography for hepatic echinococcosis and hepatic hemangioma, and the difference was statistically significant (P<0.05). The presence of arterial enhancement and absence of internal enhancement were significantly different between HHE and HAE (P<0.05). Conclusion The ultrasonographic findings of HHE and HAE were partly similar, but there were significant differences in contrastenhanced ultrasonography. HAE and HHE detection rates have been improved with CEUS, and they can be distinguished with Grayscale and CEUS.
Key words:  Contrast enhanced ultrasound  Hepatic alveolar echinococcosis  Hepatic hemangioma

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