超声造影与上腹部增强磁共振检查对肝血管瘤患者的诊断效能对比 [中文引用][英文引用]

 【摘要】  目的  分析超声造影(Contrast-enhanced Ultrasound, CEUS)与上腹部增强磁共振（MRI）扫描对肝血管瘤患者的诊断效能。方法  选择2021年1月~2022年10月在收治的86例肝血管瘤患者为对象，以患者手术病理学结果为诊断金标准，对比CEUS和上腹部MRI平扫增强扫描对肝血管瘤的诊断效能。结果  86例肝血管瘤患者，超声造影检测符合例数80例，诊断符合率为93.02%，上腹部增强磁共振扫描检测符合例数75例，诊断符合率为87.21%，超声造影和上腹部增强磁共振扫描诊断符合率对比（93.02%vs87.21%），无统计学差异（P>0.05）。超声造影和上腹部增强磁共振扫描分别对≧4mm直径的肝血管瘤的阳性检出率为90.91%（30/33）和100.00%（33/33），两组检测方式对比（P>0.05）；超声造影和上腹部增强磁共振扫描分别对<4mm直径的肝血管瘤的阳性检出率为94.34%（50/53）和79.25%（42/53），超声造影检出率高于上腹部增强磁共振扫描（P<0.05）。超声造影：动脉期表现为斑点状、结节状向心性增强，未见中心强化，门脉期病灶向心性填充，病灶回声相较于周围组织升高，延迟期相较于周围肝实质呈缓慢式填充。上腹部增强磁共振扫描：患者肝脏部位可见低密度肿块形阴影，病灶外界面较为光滑。对比增强扫描T1、T2以及ADC图片分析发现，静脉期患者肿瘤增强范围呈扩大、扩展变化，剩余两个时相均表现为结节状强化。结论  超声造影与上腹部增强磁共振扫描在肝血管瘤患者的诊断中均具有良好的诊断效能，但超声造影在较小直径的肝血管瘤检测率相对更高，临床可将超声造影与上腹部增强磁共振扫描结合用于肝血管瘤诊断，继而有利于增加肝血管瘤疾病的诊断准确率。

 【Abstract】  Objective  To analyze the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) and upper abdominal enhanced magnetic resonance (MRI) scanning in patients with hepatic hemangioma. Methods  A total of 86 patients with hepatic hemangioma admitted from January 2021 to October 2022 were selected as subjects. The surgical pathology results of patients were used as the diagnostic gold standard to compare the diagnostic efficacy of CEUS and enhanced upper abdominal MRI plain scan for hepatic hemangioma. Results  Among the 86 patients with hepatic hemangioma, 80 cases met by CEUS, with a diagnostic coincidence rate of 93.02%; 75 cases met by upper abdominal enhanced magnetic resonance scanning, with a diagnostic coincidence rate of 87.21%. There was no significant difference in diagnostic coincidence rate between contrast-enhanced ultrasound and upper abdominal enhanced magnetic resonance scanning (93.02% vs. 87.21%, P>0.05). The positive rate of CEUS and upper abdominal enhanced magnetic resonance scanning for hepatic hemangioma with ≥ 4mm diameter was 90.91% (30/33) and 100.00% (33/33) respectively, with no statistically significant difference (P>0.05). The positive rates of CEUS and upper abdominal enhanced magnetic resonance scanning for hepatic hemangioma with <4mm diameter were 94.34% (50/53) and 79.25% (42/53) respectively. The positive rate of CEUS was higher than that of upper abdominal enhanced magnetic resonance scanning (P<0.05). CEUS: The arterial stage showed spot-like and nodular centripetal enhancement without central enhancement; the portal stage showed centripetal filling, the lesion echo increased compared to the surrounding tissue; the delayed stage showed slow filling compared to the surrounding liver parenchyma. Upper abdominal enhanced magnetic resonance scanning: low density mass shadow could be seen in the liver of the patient, and the external surface of the lesion was smooth. Compared with T1, T2 and ADC images, it was found that the scope of tumor enhancement in venous stage was enlarged and expanded, and the remaining two phases showed nodular enhancement. Conclusion  Both CEUS and contrast-enhanced magnetic resonance scanning have good diagnostic efficacy in the diagnosis of hepatic hemangioma patients, but CEUS has a relatively higher detection rate in small-diameter hepatic hemangioma. CEUS and contrast-enhanced magnetic resonance scanning in the upper abdomen can be used in the diagnosis of hepatic hemangioma clinically, which is conducive to increasing the diagnostic accuracy of hepatic hemangioma disease.