Görg Christian, Graef Christine, Bert Tillmann
Klinik für Hämatologie/Onkologie, Baldingerstrasse, D-35033 Marburg, Germany.
J Ultrasound Med. 2006 Jun;25(6):729-34. doi: 10.7863/jum.2006.25.6.729.
Second-generation contrast agents have shown spleen-specific uptake. The aim of this study was to investigate the ability of contrast-enhanced sonography (CES) to demarcate splenic lesions in patients with pain in the left upper quadrant (LUQ) and an inhomogeneous splenic texture.
From October 2003 to July 2005, 31 consecutive patients with pain in the LUQ and splenic inhomogeneity on B-mode sonography were studied by CES using a second-generation contrast agent (SonoVue; Bracco SpA, Milan, Italy). The following data were retrospectively evaluated: extent of enhancement (EE) of the spleen and focal splenic lesions was determined and classified, with the EE of surrounding tissue used as an in vivo reference. Focal splenic lesions were classified after CES as round or wedge shaped, solitary or multiple, and anechoic, hypoechoic, or hyperechoic.
The EE of the spleen after CES was anechoic (n = 1), hypoechoic (n = 1), or hyperechoic (n = 29). In 16 of 31 patients, focal lesions were seen after CES. The EE of the lesions was anechoic (n = 11) or hypoechoic (n = 5). Lesions were solitary (n = 6) or multiple (n = 10) and round (n = 5) or wedge shaped (n = 11). Final clinical diagnoses of splenic abnormalities were no specific diagnosis (n = 13), complete autosplenectomy (n = 2), splenic lymphoma (n = 5), and splenic infarction (n = 11). The CES diagnoses were confirmed by computed tomography (n = 21), scintigraphy (n = 2), magnetic resonance imaging (n = 1), and clinical follow-up (n = 7).
In patients with pain in the LUQ and splenic inhomogeneity, CES enables visualization of splenic abnormalities in more than 50% of the patients; in this group, splenic infarction was the most common diagnosis.
第二代造影剂已显示出脾脏特异性摄取。本研究的目的是探讨超声造影（CES）对左上腹（LUQ）疼痛且脾脏质地不均匀患者脾脏病变的界定能力。
2003年10月至2005年7月，对31例连续的LUQ疼痛且B超显示脾脏不均匀的患者使用第二代造影剂（声诺维；意大利米兰的博莱科公司）进行CES研究。回顾性评估以下数据：确定并分类脾脏和局灶性脾脏病变的增强程度（EE），以周围组织的EE作为体内参考。CES后将局灶性脾脏病变分类为圆形或楔形、单发或多发，以及无回声、低回声或高回声。
CES后脾脏的EE为无回声（n = 1）、低回声（n = 1）或高回声（n = 29）。31例患者中有16例在CES后发现局灶性病变。病变的EE为无回声（n = 11）或低回声（n = 5）。病变为单发（n = 6）或多发（n = 10），圆形（n = 5）或楔形（n = 11）。脾脏异常的最终临床诊断为无特异性诊断（n = 13）、完全自体脾切除（n = 2）、脾脏淋巴瘤（n = 5）和脾梗死（n = 11）。CES诊断通过计算机断层扫描（n = 21）、闪烁显像（n = 2）、磁共振成像（n = 1）和临床随访（n = 7）得到证实。
在LUQ疼痛且脾脏不均匀的患者中，CES能使超过50%的患者显示脾脏异常；在该组中，脾梗死是最常见的诊断。
