Dynamic enhancing vascular pattern of intrahepatic peripheral cholangiocarcinoma on contrast-enhanced ultrasound: the influence of chronic hepatitis and cirrhosis
Dynamic enhancing vascular pattern of intrahepatic peripheral cholangiocarcinoma on contrast-enhanced ultrasound: the influence of chronic hepatitis and cirrhosis
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DOI：
10.1007/s00261-012-9854-x
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发表时间：
2013-02-01
影响因子：
--
通讯作者：
Yan, Xiao-Chu
中科院分区：
文献类型：
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作者：
Li, Rui;Zhang, Xiaohang;Yan, Xiao-Chu
为分析慢性肝炎和肝硬变患者肝内周围型胆管细胞癌(ICC)的实时超声造影动态增强特征，在注射造影剂2.4mL后，采用机械指数为<；0.2的对比脉冲序列(CPS)成像技术进行CEUS检查。对54例患者(慢性乙型肝炎15例，肝硬变16例，基础肝脏正常23例)的肝内胆管癌变的CEUS图像进行了分析，动脉期肝内胆管内不均匀高强化的发生率慢性肝炎(9/15，60.0%，p=0.000)和肝硬变(8/16，50.0%，p=0.010)明显高于正常肝(6/23，26.1%)。23例正常肝患者中13例(56.5%)表现为周边高强化，明显高于慢性肝炎(4例，26.7%)和肝硬化组(5例，31.3%，p=0.001)。慢性肝炎和肝硬变患者肝内胆汁淤积(11/15，73.3%，p=0.000)和肝硬变患者(11/16，68.8%，p=0.000)较肝实质正常的肝内胆汁淤积(8/23，34.8%)多见。慢性肝炎和肝硬变患者肝内胆汁淤积增强的血管形态与无基础肝病的肝内胆管造影不同。在大多数慢性肝炎或肝硬变患者的CEUS上，增强的血管形态与肝细胞癌难以区分。
To analyse the dynamic enhancing features by real-time contrast-enhanced ultrasound (CEUS) of intrahepatic peripheral cholangiocarcinoma (ICC) in patients with chronic hepatitis and cirrhosis.CEUS was performed by using contrast pulse sequencing (CPS) imaging with mechanical index of < 0.2 after injection of 2.4 mL of contrast agent. CEUS images of histologically confirmed ICC in 54 patents (15 patents with chronic hepatitis B, 16 patents with cirrhosis, and 23 patents with normal underlying liver) were analyzed.Heterogeneous hyperenhancement was more frequently identified in ICC with chronic hepatitis (9 of 15, 60.0%, p = 0.000) and cirrhosis (8 of 16, 50.0%, p = 0.010) than in patients with normal liver (6 of 23, 26.1%) during arterial phase. The majority of ICC in patients with normal liver displayed peripheral hyperenhancement (13 of 23, 56.5%), than in patients with chronic hepatitis (4 of 15, 26.7%, p = 0.000) and cirrhosis (5 of 16, 31.3%, p = 0.001). Intense contrast uptake during the arterial phase (heterogeneous hyperenhancement or global hyperenhancement) followed by washout in venous phases was more frequently displayed in ICC patients with chronic hepatitis (11 of 15, 73.3%, p = 0.000) and in patients with cirrhosis (11 of 16, 68.8%, p = 0.000) than in ICC patients with normal underlying liver (8 of 23, 34.8%).The enhancing vascular pattern of ICC on CEUS in patients with chronic hepatitis and cirrhosis is different from that in ICC without underlying liver disease. The enhancing vascular pattern is indistinguishable from HCC on CEUS in most ICC patients with chronic hepatitis or cirrhosis.