论著-头颈部
超声造影结合CT在肝局灶性结节增生诊断中的应用价值*
作者:贺利霞1 刘晓妮1 蒋 洁2 毛卫霞3
所属单位:1.陕西省榆林市第二医院超声诊断科(陕西 榆林 719000) 2.北京大学第三医院超声医学科(北京 100191) 3.陕西省榆林市第二医院CT室(陕西 榆林 719000)
PDF摘要
目的超声造影结合CT在肝局灶 性结节增生(FNH)诊断中的应用价值。方 法 选择2016年1月到2018年1月到医院就 诊FNH患者100例,所有患者均进行CT及超 声造影检测。分析CT与超声造影表现特 点,比较CT、超声造影、CT联合超声造影 检测FNH准确率。结果 FNH患者CT表现为 动脉期均匀强化,超声造影表现为动脉期 快速、均匀高增强;CT检测出80个病灶, 平扫显示44个病灶为低密度,在动脉期明 显强化,在静脉期及延迟期,分别有24及 26个病灶密度降低为等密度;超声造影检 测出85个病灶,动脉期可见83个高回声病 灶,静脉期及延迟期分别有16及50个病灶 降低为等回声;CT结合超声造影检测FNH 患者检出率明显高于单独检测,差异有统 计学意义(P<0.05)。结论 超声造影结合 CT诊断FNH检出符合率较单独检查更高。
Objective To evaluate the application value of contrast-enhanced ultrasound combined with CT in the diagnosis of focal nodular hyperplasia (FNH). Methods A total of 100 cases of patients with FNH who were enrolled in the hospital from January 2016 to January 2018 were selected for the study. All patients were given CT and contrast-enhanced ultrasound. The findings features of CT and contrast-enhanced ultrasound were analyzed. CT and contrast-enhanced ultrasonography were analyzed to compare the accuracy of CT, contrast-enhanced ultrasonography and CT combined with contrast-enhanced ultrasonography in detecting FNH. Results The CT findings of FNH showed that the lesions were evenly enhanced in arterial phase, and the findings of contrast-enhanced ultrasound showed lesions were with rapid and uniform and high enhancement in arterial phase. A total of 80 lesions were detected by CT, and the plain scan showed that 44 lesions were low-density and significantly enhanced in arterial phase, in venous phase and delayed phase, 24 and 26 lesions decreased to iso-density, respectively. 85 lesions were detected by contrast-enhanced ultrasound, and 83 lesions were hyperechoic in arterial phase, and 16 lesions in venous phase and 50 lesions in delayed phase were reduced to equal echo. The detection rate of FNH patients by CT combined with contrast-enhanced ultrasound was significantly higher than that by single detection(P<0.05). Conclusion Contrast-enhanced ultrasound combined with CT has a high detection rate in the diagnosis of FNH.
【关键词】超声造影;电子计算机断层扫描;肝局灶性结节增生;诊断
【中图分类号】R73;R81
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.12.030
前言
肝局灶性结节增生(FNH)是一种良性肿瘤样病变,临床诊断困难, 容易与原发肝癌混淆[1]。FNH病理表现为病灶中心有星形瘢痕并被放 射状纤维分隔开,是一个实质性肿块,并且边界清晰、无包膜、呈黄 褐色[2]。FNH多见于青年女性人群,通常为单发者。目前,尚未明确 HFN病因,有研究认为是肝脏局部动脉畸形导致局部血液过度灌注肝组 织,引起肝细胞反应性增生,雌性激素也可能利于病灶生长[3]。大部 分患者无明显症状,存在症状患者表现为右上腹部疼痛、肝肿大等, 体检可触及右侧肋缘硬质包块,可随人体呼吸移动。FNH通常无恶变可 能,对于无破裂出血或坏死患者可保守治疗,对穿刺检查后仍无法辨 别良恶性患者需手术治疗[4]。CT是临床常用检测方式[5],超声造影因其 实时性动态检测也越来越多应用于肝脏良恶性肿瘤的诊断。基于此, 本研究采用超声造影结合CT诊断FNH,以探讨在FNH的诊断价值,现作 如下报告。
中国CT和MRI杂志
第16卷, 第 12 期
2018年12月
相关文章