SONOGRAPHY WITH INTRAARTERIAL INFUSION OF CARBON-DIOXIDE MICROBUBBLES (SONOGRAPHIC ANGIOGRAPHY) - VALUE IN DIFFERENTIAL-DIAGNOSIS OF HEPATIC-TUMORS
SONOGRAPHY WITH INTRAARTERIAL INFUSION OF CARBON-DIOXIDE MICROBUBBLES (SONOGRAPHIC ANGIOGRAPHY) - VALUE IN DIFFERENTIAL-DIAGNOSIS OF HEPATIC-TUMORS
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DOI：
10.2214/ajr.158.1.1309220
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发表时间：
1992-01-01
影响因子：
5
通讯作者：
TODO, A
中科院分区：
文献类型：
--
作者：
KUDO, M;TOMITA, S;TODO, A
小的肝肿瘤的鉴别诊断是重要的，但并不总是可能的，即使有血管造影。为了解决这一问题，我们引入了超声血管造影，它将超声和血管造影相结合。应用超声血管造影对多种肝结节的血管形态进行评价，并与常规血管造影结果进行比较。超声血管造影（动脉内注入二氧化碳微泡时进行超声）184例，共222例肝结节：139例肝细胞癌，9例腺瘤性增生，7例再生结节，21例血管瘤，33例转移瘤，7例淋巴瘤，1例肉芽肿，5例局灶性结节增生。超声血管造影在肝细胞癌病例中检测到外周血供血的高血管模式（敏感性90%，特异性89%）。腺瘤性增生、血管瘤、转移和局灶性结节性增生的典型血管形态分别为低血管（敏感性100%，特异性91%）、点状池化（敏感性100%，特异性100%）、外周血管高血管（敏感性64%，特异性100%）和中心动脉供应（敏感性100%，特异性100%）。超声血管造影对肝细胞癌、转移瘤和血管瘤血管增生的检出率高于常规血管造影。我们的经验表明，超声血管造影描绘了特征性的血管特征，反映了特定类型肝脏肿瘤的血管解剖结构，因此对这些病变的鉴别诊断是有用的。
Differential diagnosis of small liver tumors is important, but is not always possible, even with angiography. To solve this problem, we introduced sonographic angiography, which combines sonography and angiography. The vascular pattern of a variety of hepatic nodules was evaluated with sonographic angiography, and the results were compared with those of conventional angiography. Sonographic angiography (sonography performed during intraarterial infusion of carbon dioxide microbubbles) was performed in 184 patients with a total of 222 hepatic nodules: 139 hepatocellular carcinomas, nine adenomatous hyperplasias, seven regenerative nodules, 21 hemangiomas, 33 metastases, seven lymphomas, one granuloma, and five focal nodular hyperplasias. Sonographic angiography detected a hypervascular pattern with peripheral blood supply in cases of hepatocellular carcinoma (sensitivity, 90%; specificity, 89%). Typical vascular patterns of adenomatous hyperplasia, hemangioma, metastasis, and focal nodular hyperplasia on sonographic angiography were hypovascularity (sensitivity, 100%; specificity, 91%), spotty pooling (sensitivity, 100%; specificity, 100%), peripheral hypervascularity (sensitivity, 64%; specificity, 100%), and a central arterial supply (sensitivity, 100%; specificity, 100%), respectively. The detectability of hypervascularity was greater with sonographic angiography than with conventional angiography in hepatocellular carcinoma, metastasis, and hemangioma.Our experience indicates that sonographic angiography depicts characteristic vascular features that reflect the vascular anatomy of specific types of hepatic tumors, and thus is useful in the differential diagnosis of these lesions.