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目的探究超声造影对脂肪肝背景下肝内局灶性病变的诊断价值。方法 80例常规超声检查无法确诊的脂肪肝背景下肝内局灶性病变患者作为研究对象,均进行二维超声、彩色多普勒超声、超声造影检查,统计分析检查结果。结果常规二维超声检查显示,低回声44例,高回声28例,等回声5例,混合回声3例。经过超声造影检查与病理结果相符为血管瘤41例,非均匀性脂肪肝10例,肝局灶性结节增生7例,炎性假瘤7例,自发性血肿4例,腺瘤3例,炎性病灶3例,脂肪肝合并恶性肿瘤3例,诊断准确率为97.50%(78/80);二维超声结合彩色多普勒超声检查与病理结果相符为血管瘤27例,非均匀性脂肪肝6例,肝局灶性结节增生2例,诊断准确率为43.75%(35/80);超声造影对脂肪肝背景下肝内局灶性病变诊断准确率显著高于二维超声结合彩色多普勒超声检查,差异具有统计学意义(P<0.05)。结论超声造影对脂肪肝背景下肝内局灶性病变具有重要诊断价值,对于部分缺少特异性表现的病例,则须再进行活检穿刺来诊断。
Objective To investigate the diagnostic value of contrast-enhanced ultrasound in the diagnosis of focal intrahepatic lesions in fatty liver. Methods Totally 80 patients with intrahepatic focal lesion who could not be diagnosed by routine ultrasonography were studied by two-dimensional ultrasonography, color Doppler ultrasound and contrast-enhanced ultrasound, and the results of statistical analysis were analyzed. Results Conventional two-dimensional ultrasound showed 44 cases of hypoechoic, 28 cases of hyperechoic, 5 cases of equal echo and 3 cases of mixed echo. After contrast-enhanced ultrasound and pathological findings, 41 hemangiomas, 10 non-uniform fatty liver, 7 hepatic focal nodular hyperplasia, 7 inflammatory pseudotumor, 4 spontaneous hematoma, 3 adenoma, 3 cases of inflammatory lesions, 3 cases of fatty liver associated with malignant tumors, the diagnostic accuracy was 97.50% (78/80); two-dimensional ultrasound combined with color Doppler ultrasound and pathological findings consistent with hemangioma in 27 cases, non-uniform fat Liver in 6 cases, focal nodular hyperplasia in 2 cases, diagnostic accuracy was 43.75% (35/80); contrast-enhanced ultrasound in the diagnosis of focal liver lesions in fatty liver was significantly higher than the two-dimensional ultrasound combined with color Doppler ultrasound, the difference was statistically significant (P <0.05). Conclusion Contrast-enhanced ultrasound is of value in the diagnosis of focal intrahepatic lesions in the fatty liver. For some cases with no specific manifestation, biopsy should be performed again.