超聲造影在肝臟局灶性結節樣增生診斷中的應用_《中國普外基礎與臨床雜志》

作者：

盧強 ¹ , 黃子星 ² , 鐘曉緋 ¹ , 茍廷坤 ¹ , 羅燕 ¹

1.四川大學華西醫院超聲科(成都 610041);;
2.四川大學華西醫院放射科(成都 610041);

關鍵詞：

超聲造影診斷肝臟腫瘤局灶性結節樣增生

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目的　探討肝臟局灶性結節樣增生(FNH)的超聲造影表現，旨在提高超聲造影對FNH診斷的認識。
方法　收集2007年5月至2009年2月期間在四川大學華西醫院行超聲造影檢查并經病理檢查證實的FNH患者12例，并復習有關文獻。
結果　超聲造影動脈期全部病灶均迅速強化，9/12例病灶動脈期可探及“輪輻狀”增強，實質期有11/12例病灶呈稍高或等增強,1/12例病灶呈稍低增強。
結論　超聲造影能動態顯示FNH的血流灌注，特別是動脈期的“輪輻狀”血流對FNH的診斷具有重要價值。

引用本文： 盧強,黃子星,鐘曉緋,茍廷坤,羅燕. 超聲造影在肝臟局灶性結節樣增生診斷中的應用. 中國普外基礎與臨床雜志, 2010, 17(4): 403-407. doi: 復制

1.	Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis [J]. Radiographics, 2004; 24(1): 3-17.
2.	張磊, 蔡建強, 趙建軍, 等. 肝臟局灶性結節性增生 [J]. 中國普通外科雜志, 2009; 18(7): 749-751.
3.	周玉保, 汪慧, 周華邦, 等. 肝臟局灶性結節性增生46例臨床分析 [J]. 臨床消化病雜志, 2009; 21(3): 146-149.
4.	張建偉, 王成鋒, 劉騫, 等. 肝臟局灶性結節性增生的臨床診治分析 [J]. 中華醫學雜志, 2007; 87(36): 2531-2533.
5.	蘭明銀, 周猛, 胡玲, 等. 肝臟局灶性結節性增生的診療分析 [J]. 外科理論與實踐, 2007; 12(4): 381-382.
6.	Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)-update 2008 [J]. Ultraschall Med, 2008; 29(1): 28-44.
7.	Ding H, Wang WP, Huang BJ, et al. Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue [J]. J Ultrasound Med, 2005; 24(3): 285-297.
8.	Li R, Guo Y, Hua X, et al. Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT [J]. J Clin Ultrasound, 2007; 35(3): 109-117.
9.	Sidhu PS. The EFSUMB guidelines for contrast-enhanced ultrasound are comprehensive and informative for good clinical practice: will radiologists take the lead? [J]. Br J Radiol, 2008; 81(967): 524-525.
10.	李迎春, 宋彬, 蔣莉莉, 等. 新型MR造影劑釓貝葡胺診斷肝臟局灶性結節樣增生的價值(附5例報告) [J]. 中國普外基礎與臨床雜志, 2007; 15(5): 598-604.
11.	Nguyen BN, Flejou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms [J]. Am J Surg Pathol, 1999; 23(12): 1441-1445.
12.	紀元, 朱雄增, 譚云山, 等. 肝局灶性結節性增生的臨床病理學研究 [J]. 中華病理學雜志, 2000; 29(5): 334-338.
13.	鄧晶，胡建群，林紅軍，等. 肝臟局灶性結節增生的超聲造影診斷 [J]. 南京醫科大學學報（自然科學版）, 2008; 28(5): 681-684.
14.	程志剛, Weskott H. 肝臟局灶性結節性增生的超聲造影表現 [J]. 中國超聲醫學雜志, 2008; 24(11): 1042-1046.
15.	路小軍, 黃道中. 超聲造影結合新時相劃分在肝臟局灶性結節性增生診斷中的價值 [J]. 中國醫學影像技術, 2008; 24(9): 1431-1433.
16.	Ungermann L, Eliás P, Zizka J, et al. Focal nodular hyperplasia: spoke-wheel arterial pattern and other signs on dynamic contrast-enhanced ultrasonography [J]. Eur J Radiol, 2007; 63(2): 290-294.
17.	Bartolotta TV, Midiri M, Quaia E, et al. Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography [J]. Eur Radiol, 2005; 15(8): 1643-1649.
18.	Strobel D, Seitz K, Blank W, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions-diagnostic accuracy in clinical practice (DEGUM multicenter trial) [J]. Ultraschall Med, 2008; 29(5): 499-505.
19.	Dietrich CF, Schuessler G, Trojan J, et al. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound [J]. Br J Radiol, 2005; 78(932): 704-707.
20.	潘思波, 葉觀瑞, 車斯堯. 肝細胞腺瘤的診斷及治療 [J]. 中國現代普通外科進展, 2009; 12(5): 414-416.
21.	Celli N, Gaiani S, Piscaglia F, et al. Characterization of liver lesions by real-time contrast-enhanced ultrasonography [J]. Eur J Gastroenterol Hepatol, 2007; 19(1): 3-14.
22.	丁紅, 王文平, 黃備建, 等. 超聲造影檢測和診斷小肝癌的價值 [J]. 中國普外基礎與臨床雜志, 2007; 15(1): 28-31.
23.	Morin SH, Lim AK, Cobbold JF, et al. Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions [J]. World J Gastroenterol, 2007; 13(45): 5963-5670.
24.	Rettenbacher T. Focal liver lesions: role of contrast-enhanced ultrasound [J]. Eur J Radiol, 2007; 64(2): 173-182.
25.	D’Onofrio M, Faccioli N, Zamboni G, et al. Focal liver lesions in cirrhosis: value of contrast-enhanced ultrasonography compared with Doppler ultrasound and alpha-fetoprotein levels [J]. Radiol Med, 2008; 113(7): 978-991.

1. Hussain SM, Terkivatan T, Zondervan PE, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis [J]. Radiographics, 2004; 24(1): 3-17.
2. 　張磊, 蔡建強, 趙建軍, 等. 肝臟局灶性結節性增生 [J]. 中國普通外科雜志, 2009; 18(7): 749-751.
3. 　周玉保, 汪慧, 周華邦, 等. 肝臟局灶性結節性增生46例臨床分析 [J]. 臨床消化病雜志, 2009; 21(3): 146-149.
4. 　張建偉, 王成鋒, 劉騫, 等. 肝臟局灶性結節性增生的臨床診治分析 [J]. 中華醫學雜志, 2007; 87(36): 2531-2533.
5. 　蘭明銀, 周猛, 胡玲, 等. 肝臟局灶性結節性增生的診療分析 [J]. 外科理論與實踐, 2007; 12(4): 381-382.
6. 　Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)-update 2008 [J]. Ultraschall Med, 2008; 29(1): 28-44.
7. 　Ding H, Wang WP, Huang BJ, et al. Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue [J]. J Ultrasound Med, 2005; 24(3): 285-297.
8. 　Li R, Guo Y, Hua X, et al. Characterization of focal liver lesions: comparison of pulse-inversion harmonic contrast-enhanced sonography with contrast-enhanced CT [J]. J Clin Ultrasound, 2007; 35(3): 109-117.
9. 　Sidhu PS. The EFSUMB guidelines for contrast-enhanced ultrasound are comprehensive and informative for good clinical practice: will radiologists take the lead? [J]. Br J Radiol, 2008; 81(967): 524-525.
10. 　李迎春, 宋彬, 蔣莉莉, 等. 新型MR造影劑釓貝葡胺診斷肝臟局灶性結節樣增生的價值(附5例報告) [J]. 中國普外基礎與臨床雜志, 2007; 15(5): 598-604.
11. 　Nguyen BN, Flejou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms [J]. Am J Surg Pathol, 1999; 23(12): 1441-1445.
12. 　紀元, 朱雄增, 譚云山, 等. 肝局灶性結節性增生的臨床病理學研究 [J]. 中華病理學雜志, 2000; 29(5): 334-338.
13. 　鄧晶，胡建群，林紅軍，等. 肝臟局灶性結節增生的超聲造影診斷 [J]. 南京醫科大學學報（自然科學版）, 2008; 28(5): 681-684.
14. 　程志剛, Weskott H. 肝臟局灶性結節性增生的超聲造影表現 [J]. 中國超聲醫學雜志, 2008; 24(11): 1042-1046.
15. 　路小軍, 黃道中. 超聲造影結合新時相劃分在肝臟局灶性結節性增生診斷中的價值 [J]. 中國醫學影像技術, 2008; 24(9): 1431-1433.
16. 　Ungermann L, Eliás P, Zizka J, et al. Focal nodular hyperplasia: spoke-wheel arterial pattern and other signs on dynamic contrast-enhanced ultrasonography [J]. Eur J Radiol, 2007; 63(2): 290-294.
17. 　Bartolotta TV, Midiri M, Quaia E, et al. Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography [J]. Eur Radiol, 2005; 15(8): 1643-1649.
18. 　Strobel D, Seitz K, Blank W, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions-diagnostic accuracy in clinical practice (DEGUM multicenter trial) [J]. Ultraschall Med, 2008; 29(5): 499-505.
19. 　Dietrich CF, Schuessler G, Trojan J, et al. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound [J]. Br J Radiol, 2005; 78(932): 704-707.
20. 　潘思波, 葉觀瑞, 車斯堯. 肝細胞腺瘤的診斷及治療 [J]. 中國現代普通外科進展, 2009; 12(5): 414-416.
21. 　Celli N, Gaiani S, Piscaglia F, et al. Characterization of liver lesions by real-time contrast-enhanced ultrasonography [J]. Eur J Gastroenterol Hepatol, 2007; 19(1): 3-14.
22. 　丁紅, 王文平, 黃備建, 等. 超聲造影檢測和診斷小肝癌的價值 [J]. 中國普外基礎與臨床雜志, 2007; 15(1): 28-31.
23. 　Morin SH, Lim AK, Cobbold JF, et al. Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions [J]. World J Gastroenterol, 2007; 13(45): 5963-5670.
24. 　Rettenbacher T. Focal liver lesions: role of contrast-enhanced ultrasound [J]. Eur J Radiol, 2007; 64(2): 173-182.
25. 　D’Onofrio M, Faccioli N, Zamboni G, et al. Focal liver lesions in cirrhosis: value of contrast-enhanced ultrasonography compared with Doppler ultrasound and alpha-fetoprotein levels [J]. Radiol Med, 2008; 113(7): 978-991.

《中國普外基礎與臨床雜志》

超聲造影在肝臟局灶性結節樣增生診斷中的應用

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《中國普外基礎與臨床雜志》

超聲造影在肝臟局灶性結節樣增生診斷中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料