Contrast-enhanced ultrasonographic findings of hepatic paragonimiasis
Contrast-enhanced ultrasonographic findings of hepatic paragonimiasis
复制标题
肝肺吸虫病的超声造影表现
DOI：
10.3748/wjg.v19.i13.2087
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发表时间：
2013-04-07
影响因子：
4.3
通讯作者：
Luo, Yan
中科院分区：
文献类型：
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作者：
Lu, Qiang;Ling, Wen-Wu;Luo, Yan
目的：目的：探讨肝并殖吸虫病的超声造影（CEUS）特征。方法：收集2008年3月至2012年8月我院收治的肝并殖吸虫病患者15例。常规超声和CEUS检查均采用Philips IU 22型超声仪，凸面探头频率1-5 MHz。完成常规超声扫描后，进行CEUS研究。超声造影采用脉冲反转谐波成像。推注2.4 mL六氟化硫填充微泡造影剂（SonoVue）。结果：共检出16个病灶，其中16个病灶的超声造影表现与病理结果一致。病变的平均尺寸为4.4 ± 1.6 cm（范围：1.7-6.6 cm）。12个病灶（75%）位于包膜下。所有病灶均为低回声。6例（37.5%）为混合性内容物，7例（43.8%）为实性伴小囊变，3例（18.8%）为完全实性。10个病灶（62.5%）呈边缘强化，内部呈不规则条状非强化区。7个（43.8%）病灶周围肝实质呈一过性楔形强化。动脉期高或等增强区显示造影剂洗脱，晚期显示低增强。主要病理表现为：（1）病灶内凝固性或凝固性坏死，大量嗜酸性粒细胞浸润，形成慢性嗜酸性粒细胞浸润，散在分布夏-莱二氏结晶;（2）病灶周围肉芽肿性和纤维组织增生。肝并殖吸虫囊下定位、低回声、边缘强化及条索样无强化区是其CEUS的主要特征。(C)2013年百世登。All rights reserved.
AIM: To investigate the features of hepatic paragonimiasis on contrast-enhanced ultrasound (CEUS) imaging.METHODS: Fifteen patients with hepatic paragonimiasis who were admitted to our hospital between March 2008 and August 2012 were enrolled to this study. The conventional ultrasound and CEUS examinations were performed with a Philips IU22 scanner with a 1-5-MHz convex transducer. After conventional ultrasound scanning was completed, the CEUS study was performed. Pulse inversion harmonic imaging was used for CEUS. A bolus injection of 2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue) was administered. CEUS features were retrospectively reviewed and correlated with pathological findings.RESULTS: In total, 16 lesions were detected on CEUS. The mean size of the lesions was 4.4 +/- 1.6 cm (range, 1.7-6.6 cm). Subcapsular location was found in 12 lesions (75%). All the lesions were hypoechoic. Six lesions (37.5%) were of mixed content, seven (43.8%) were solid with small cystic areas, and the other three (18.8%) were completely solid. Ten lesions (62.5%) were rim enhanced with irregular tract-like nonenhanced internal areas. Transient wedge-shaped hyperenhancement of the surrounding liver parenchyma was seen in seven lesions (43.8%). Areas with hyper-or iso-enhancement in the arterial phase showed contrast wash-out and appeared hypoenhanced in the late phase. The main pathological findings included: (1) coagulative or liquefactive necrosis within the lesion, infiltration of a large number of eosinophils with the formation of chronic eosinophilic abscesses and sporadic distribution of Charcot-Leyden crystals; and (2) hyperplasia of granulomatous and fibrous tissue around the lesion.CONCLUSION: Subcapsular location, hypoechogenicity, rim enhancement and tract-like nonenhanced areas could be seen as the main CEUS features of hepatic paragonimiasis. (C) 2013 Baishideng. All rights reserved.