Contrast harmonic imaging characterization of canine splenic lesions
Contrast harmonic imaging characterization of canine splenic lesions
复制标题
DOI：
10.1111/j.1939-1676.2008.0154.x
复制
发表时间：
2008-09-01
影响因子：
2.6
通讯作者：
Kaser-Hotz, B.
中科院分区：
文献类型：
--
作者：
Ohlerth, S.;Dennler, M.;Kaser-Hotz, B.
背景：虽然B超对脾病变的检出非常敏感，但其特异性较低。声学造影技术成功地应用于人和犬的肝脏良恶性病变的鉴别诊断。目的：应用声学造影剂超声造影剂声学造影剂SonoVue，对60只经腹部超声检查发现脾病变的犬(临床患者)进行前瞻性研究。结果：细胞学或组织学诊断良性病变27例(增生性、髓外血肿)，恶性29例(血管肉瘤、恶性淋巴瘤、恶性组织细胞增生症、未分类间充质瘤、肥大细胞瘤等)，正常脾4例。除1例良性结节外，广泛至中度低回声仅见于恶性病变的冲入、强化高峰和冲洗期(P=0.0001，优势比分别为37.9[95%CI4.5~316.5]、66.4[95%CI8.0~551.1]和36.9[95%CI4.4~308.4])。尽管除1个良性病变外，所有良性病变在所有血液池期均较正常脾呈轻度低、等或高回声，但良性和恶性脾病变均有显著强化。良性病变和恶性病变之间的定量灌注值没有显著差异。结论和临床意义：中度到广泛的低回声可以清楚地识别犬脾恶性病变。对于有明显强化的结节，超声造影剂的价值有限，需要进行组织学检查。
Background: Although B-mode ultrasound is very sensitive for the detection of splenic lesions, its specificity is low. Contrast harmonic imaging is used successfully to differentiate benign from malignant liver lesions in humans and dogs.Hypothesis: Contrast harmonic imaging could be useful to differentiate benign and malignant splenic lesions in dogs.Animals: Sixty dogs (clinical patients) with splenic abnormalities detected during abdominal ultrasonography.Methods: A prospective study was performed with a Philips ATL 5000 unit for contrast pulse inversion harmonic imaging (mechanical index: 0.08, contrast medium: SonoVue). Perfusion was assessed subjectively and quantitatively.Results: Cytology or histology identified 27 benign (hyperplasia, extramedullary hematopoiesis, hematoma) and 29 malignant (hemangiosarcoma, malignant lymphoma, malignant histiocytosis, mesenchymal tumors without classification, mast cell tumors, and others) lesions and 4 normal spleens. Except for 1 benign nodule, extensive to moderate hypoechogenicity was only seen in malignant lesions during wash-in, at peak enhancement, and during wash-out (P = .0001, odds ratios: 37.9 [95% CI 4.5-316.5], 66.4 [95% CI 8.0-551.1], and 36.9 [95% CI 4.4-308.4]). Although all but 1 benign lesion enhanced well and were mildly hypo-, iso-, or hyperechoic in comparison with the normal spleen during all blood pool phases, marked enhancement occurred both in benign as well as in malignant splenic lesions. Quantitative perfusion values did not differ significantly between benign and malignant lesions.Conclusions and Clinical Importance: Moderate to extensive hypoechogenicity clearly identifies canine splenic malignant lesions. In nodules with marked enhancement, contrast harmonic ultrasound is of limited value and histology is needed.