文章摘要

肝孤立性坏死结节的超声造影表现

作者: 1卢春雨, 1唐少珊, 1张潇月, 1王阳, 1王凯明, 1沈鹏
1 中国医科大学附属盛京医院超声科,沈阳 110004
通讯: 唐少珊 Email: tangss@sj-hospital.org
DOI: 10.3978/j.issn.2095-6959.2020.10.014

摘要

目的:总结肝孤立性坏死结节(solitary necrotic nodule,SNN)的超声造影表现,分析误诊原因,提高超声造影对该病的认识。方法:回顾性分析以超声造影或病理诊断为SNN的68名患者的超声造影表现及临床资料,评估超声造影对SNN的诊断效能,对误诊原因进行分析。结果:在68例患者中,66例经病理或随访证实为SNN,2例病理证实为肝癌;超声造影正确诊断SNN 65例,误诊为SNN 2例,误诊为转移癌1例,超声造影诊断符合率为95.59%(65/68)。SNN的典型超声造影表现为病灶整体三相无增强,伴或不伴有周边薄环状、内部纤细分隔样增强,门脉相及延迟相增强部分无消退。结论:SNN的超声造影有典型表现,具有较高的诊断效能,值得推广使用。
关键词: 孤立性坏死结节;超声造影;误诊;鉴别

Contrast-enhanced ultrasonography appearances of solitary necrotic nodules of the liver

Authors: 1LU Chunyu, 1TANG Shaoshan, 1ZHANG Xiaoyue, 1WANG Yang, 1WANG Kaiming, 1SHEN Peng
1 Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, China

CorrespondingAuthor: TANG Shaoshan Email: tangss@sj-hospital.org

Abstract

Objective: To summary the appearances on contrast-enhanced ultrasonography of solitary necrotic nodules (SNN) of the liver, analyze the reasons of misdiagnosed cases, and improve the understanding of the disease. Methods: The contrast-enhanced ultrasonography and clinical data of 68 patients diagnosed SNN by contrast-enhanced ultrasonography or pathology were analyzed retrospectively. The diagnostic efficacy of contrast-enhanced ultrasonography in the diagnosis of SNN was evaluated and the reasons of misdiagnosis were analyzed. Results: In the 68 patients, 66 cases were confirmed as SNN by pathology or follow-up, 2 cases were confirmed hepatocellular carcinoma by pathology. On contrast-enhanced ultrasonography, 65 cases were correctly diagnosed as SNN, 2 cases were misdiagnosed as SNN, and 1 case was misdiagnosed as metastatic carcinoma. The diagnostic accordance rate of contrast-enhanced ultrasonography was 95.59% (65/68). The typical contrast-enhanced ultrasonographic appearances of SNN were as follows: there was no enhancement in the whole three-phase of the lesions, with or without peripheral thin rim-like and internal septum-like enhancement and without contrast agent decreasing in portal phase nor delayed phase. Conclusion: SNN has typical contrast-enhanced ultrasonography appearances with high diagnostic efficiency, which is worthy of clinical application.
Keywords: solitary necrotic nodules; contrast-enhanced ultrasonography; misdiagnosis; differentiation