Ultrasound features of hepatocellular adenoma and the additional value of contrast-enhanced ultrasound
Ultrasound features of hepatocellular adenoma and the additional value of contrast-enhanced ultrasound
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DOI：
10.1016/s1499-3872(15)60039-x
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发表时间：
2016-02-01
影响因子：
3.3
通讯作者：
Ji, Zheng-Biao
中科院分区：
文献类型：
--
作者：
Dong, Yi;Zhu, Zheng;Ji, Zheng-Biao
背景：肝细胞腺瘤（HCA）是一种罕见的肝脏良性肿瘤。鉴别HCA与其他肝脏肿瘤，特别是肝细胞癌（HCC）具有重要的临床意义。本研究旨在通过常规超声和超声造影（CEUS）的表现来评价HCA的特征。方法：回顾性分析26例经组织病理学证实的hca患者（男性10例，女性16例，平均年龄36.2±5.0岁）。根据hca的最大直径分为三组：50 mm。超声检查采用Philips iU22装置（Philips Bothell， WA， USA）的c2 -2宽带弯曲换能器。对于每个病变，将2.4 mL SonoVue (R) （Bracco Imaging Spa, Milan, Italy）作为快速注射剂注入肘静脉。记录病变的回声性、彩色多普勒血流显像及对比增强模式。结果：灰度超声显示hca多为低回声（73.1%,19/26）。点状钙化占26.9%（7/26）。彩色多普勒血流显像在46.2%（12/26）的hca中检测到向心块状彩色血流。超声造影显示73.1%（19/26）的hca表现为快速、完全、均匀增强，53.8%（14/26）的hca表现为晚期增强减弱。不同大小hca的增强模式差异无统计学意义（P < 0.05）。向心增强伴囊下动脉弯曲在较大的hca中很常见。结论：超声造影联合灰度和彩色多普勒血流显像有助于提高hca的术前诊断。hca的特征性影像学表现为：超声造影快速均匀增强和缓慢冲洗模式；灰度超声的非均匀回声性研究大hca的向心增强表现为囊下动脉弯曲。
BACKGROUND: Hepatocellular adenoma (HCA) is a rare benign tumor of the liver. It is of clinical importance to differentiate HCA from other liver tumors, especially hepatocellular carcinoma (HCC). This study aimed to evaluate the characteristic features of HCA by conventional ultrasound and contrast-enhanced ultrasound (CEUS) findings.METHODS: Twenty-six patients (10 males and 16 females; mean age 36.2 +/- 5.0 years) with 26 histopathologically proven HCAs were retrospectively identified. According to the maximum diameter of HCAs, they were divided into three groups: 50 mm. Ultrasound examinations were performed with C5-2 broadband curved transducer of Philips iU22 unit (Philips Bothell, WA, USA). For each lesion, a dose of 2.4 mL SonoVue (R) (Bracco Imaging Spa, Milan, Italy) was injected as a quick bolus into the cubital vein. Lesions' echogenicity, color-Doppler flow imaging and contrast enhancement patterns were recorded.RESULTS: Grayscale ultrasound revealed that most of HCAs were hypoechoic (73.1%, 19/26). Spotty calcifications were detected in 26.9% (7/26) of the lesions. Color-Doppler flow imaging detected centripetal bulky color flow in 46.2% (12/26) of the HCAs. CEUS showed that 73.1% (19/26) of the HCAs displayed as rapid, complete and homogenous enhancement, and 53.8% (14/26) showed decreased contrast enhancement in the late phase. There was no significant difference in enhancement patterns among different sizes of HCAs (P>0.05). Centripetal enhancement with subcapsular tortuous arteries was common in larger HCAs.CONCLUSIONS: CEUS combined with grayscale and color Doppler flow imaging helped to improve preoperative diagnosis of HCAs. The characteristic imaging features of HCAs included: rapid homogeneous enhancement and slow washout pattern on CEUS; heterogeneous echogenicity on grayscale ultrasound; and centripetal enhancement with subcapsular tortuous arteries in large HCAs.