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目的探讨肝脏异型增生结节的常规超声和CEUS声像图特点及其诊断价值。方法回顾性分析经增强MRI和超声引导下穿刺活检病理证实的39例肝脏异型增生结节患者的常规超声以及CEUS表现。结果常规超声显示39例病灶的平均直径(1.8±1.0)cm;偏低回声占84.62%(33/39),边界清晰占69.23%(27/39),质地欠均匀者占64.10%(25/39),94.87%(37/39)不伴声晕,94.87%(37/39)不伴后方回声增强。常规超声诊断为肝脏异型增生结节13例,诊断正确率33.33%(13/39)。CEUS示动脉期高增强占84.62%(33/39),其中28例门脉期等增强,延迟期低增强(71.79%,28/39);2例(5.13%,2/39)动脉期等增强;4例(10.26%,4/39)动脉期低增强。CEUS诊断为肝脏异型增生结节23例,诊断正确率58.97%(23/39)。结论常规超声异型增生结节多表现为边界清晰、质地欠均匀的偏低回声,且不伴声晕及后方回声增强;CEUS多以动脉期高增强、门脉期等增强、延迟期低增强表现为主,CEUS的诊断准确率明显高于常规超声。
Objective To investigate the features and diagnostic value of routine ultrasound and CEUS sonography of hepatic dysplastic nodules. Methods The routine ultrasound and CEUS findings of 39 cases of liver dysplasia nodules confirmed by enhanced MRI and ultrasound guided biopsy were retrospectively analyzed. Results The average diameter of 39 lesions was (1.8 ± 1.0) cm in conventional ultrasound, 84.62% (33/39) in low echo, 69.23% (27/39) in clear boundary and 64.10% 39), 94.87% (37/39) with no sound halo, 94.87% (37/39) with no enhanced echo. Routine ultrasound diagnosis of liver dysplasia nodules in 13 cases, the correct diagnosis rate of 33.33% (13/39). CEUS showed 84.62% (33/39) cases of high arterial phase enhancement, including 28 cases of portal phase enhancement, low delay enhancement (71.79%, 28/39), arterial phase of 2 cases (5.13%, 2/39) Enhanced in 4 cases (10.26%, 4/39) arterial phase low enhancement. CEUS diagnosis of liver dysplasia nodules in 23 cases, the correct diagnosis rate of 58.97% (23/39). Conclusions Conventional ultrasonic dysplastic nodules often show hypoechoic echo with low echo and no hypoechoicity and posterior echogenicity. CEUS mostly has high arterial phase, enhanced portal phase and low delayed enhancement phase Mainly, CEUS diagnostic accuracy was significantly higher than conventional ultrasound.