超声造影对高原地区肝脏局灶性病变的临床诊断价值

The Clinical Value of Contrast-Enhanced Ultrasound in the Diagnosis of Focal Liver Lesions in Plateau Area

摘要: 目的：通过分析高原地区肝脏局灶病变超声造影的影像学特点，为临床提供更多的诊断价值。方法：剔除了有肝硬化背景的患者，对68例常规超声检出的局灶性病变进行超声造影，分析各病灶的增强模式，并进行相关文献复习。结果：经超声造影、肿瘤标志物检测、血清学检测、CECT/CEMRI扫描及手术病理联合确诊，肝泡型包虫病23例，肝血管瘤21例，局灶性坏死结节3例，局灶性脂肪浸润13例，FNH (局灶性结节性增生) 2例，血管平滑肌脂肪瘤1例，HCC (肝细胞肝癌) 3例，ICC (胆管细胞性肝癌) 2例。结论：超声造影可以即时、实时连续观察病灶的增强模式，对肝脏绝大多数局灶性病变特别是高原地区泡型包虫病等特发病能做出明确的诊断与鉴别诊断，为临床提供更多有用的信息。

Abstract: Aim: To analyze the CEUS imaging features of hepatic focal lesions in the plateau area, and try to provide more evidence for clinical diagnosis. Method: 68 cases of focal lesions were included and detected by CEUS except for other patients with liver cirrhosis, the enhancement patterns of the lesions were analyzed and the related literatures were reviewed. Results: Totally 68 lesions with final pathologic results after surgery, all these patients had received CEUS, CECT or CEMRI, tumor markers and serological tests. There were 23 hepatic alveolar echinococcosis, 21 hepatic hemangioma, 13 focal fatty infiltration, 3 HCC, 2 ICC, 2 FNH and 1 angioleiomyolipoma. Conclusion: CEUS can provide instant, real-time continuous observation of the lesion enhancement patterns, which can help us to do right diagnosis of most liver focal lesions especially some special disease in hydatid areas such as hepatic alveolar echinococcosis, and provide more information in clinical practice.