Görg C, Bert T
Medizinische Universitätsklinik Marburg/Lahn.
Ultraschall Med. 2005 Dec;26(6):470-7. doi: 10.1055/s-2005-858904.
Contrast enhanced sonography (CES) of second generation contrast media have shown a spleen-specific uptake of the microbubble contrast agent. The aim of this study was to investigate the ability of a second generation contrast agent to enhance splenic lesions.
From October 2003 to September 2004, 46 consecutive patients with focal (peri-) splenic lesions on B-mode sonography were studied by CES using a transpulmonary second-generation contrast agent (SonoVue). Data were retrospectively evaluated. Diagnosis of the patients were infarction (n = 9), lymphoma (n = 7), metastasis (n = 6), injury (n = 4), haemangioma/splenoma (n = 6), accessory spleen (n = 3), cyst (n = 2), and unknown cause (n = 9). Diagnosed of splenic lesions was confirmed by histology (n = 5), contrast enhanced computed tomography (n = 25), MRI (n = 4), scintigraphy (n = 1), and follow up (n = 38). Extent of enhancement (EE) was evaluated during the arterial phase (5-30 s) and the parenchymal phase (3-5 minutes): EE of focal splenic lesions was determined using the surrounding splenic tissue as an in vivo reference, and classified as anechoic vs. hypoechoic vs. isoechoic vs. hyperechoic vs. mixed. The contribution of CES to the final diagnosis was classified as low, helpful or highly necessary.
In all but one patient enhancement of normal splenic tissue occurred. During the arterial and parenchymal phase, lesions were found to have anechoic 10/10, hypoechoic 12/24, isoechoic 12/7, hyperechoic 7/0 and mixed enhancement 5/5, respectively. Value of CES for final diagnosis was low n = 24 (52%) (7 lymphomas, 6 metastases, 2 cysts, 9 unknown), helpful n = 9 (20%) (4 infarctions, 2 ruptures, 3 accessory spleens) and highly necessary n = 13 (28%) (5 infarctions, 2 ruptures, 6 haemangiomas/splenomas).
Contrast-enhanced sonography is of diagnostic value in subgroups of patients with (peri-)splenic lesions (48%): including splenic infarction, splenic rupture, splenic haemangioma/splenoma, and accessory spleen.
第二代造影剂的超声造影（CES）已显示微泡造影剂可被脾脏特异性摄取。本研究的目的是探讨第二代造影剂增强脾脏病变的能力。
2003年10月至2004年9月，对46例B超检查发现有局灶性（周围性）脾脏病变的连续患者，使用经肺第二代造影剂（声诺维）进行超声造影研究。对数据进行回顾性评估。患者的诊断结果为梗死（n = 9）、淋巴瘤（n = 7）、转移瘤（n = 6）、损伤（n = 4）、血管瘤/脾瘤（n = 6）、副脾（n = 3）、囊肿（n = 2）以及病因不明（n = 9）。脾脏病变的诊断通过组织学（n = 5）、增强CT（n = 25）、MRI（n = 4）、闪烁扫描（n = 1）以及随访（n = 38）得以证实。在动脉期（5 - 30秒）和实质期（3 - 5分钟）评估增强程度（EE）：以周围脾脏组织作为体内对照，确定局灶性脾脏病变的EE，并分为无回声、低回声、等回声、高回声及混合回声。将超声造影对最终诊断的贡献分为低、有帮助或非常必要。
除1例患者外，其余患者均出现正常脾脏组织增强。在动脉期和实质期，病变分别表现为无回声10/10、低回声12/24、等回声12/7、高回声7/0及混合回声5/5。超声造影对最终诊断的价值为低，n = 24（52%）（7例淋巴瘤、6例转移瘤、2例囊肿、9例病因不明）；有帮助 n = 9（20%）（4例梗死、2例破裂、3例副脾）；非常必要 n = 13（28%）（5例梗死、2例破裂、6例血管瘤/脾瘤）。
超声造影对有（周围性）脾脏病变的患者亚组（48%）具有诊断价值，包括脾梗死、脾破裂、脾血管瘤/脾瘤及副脾。
