Kong Wen-Tao, Wang Wen-Ping, Cai Hao, Huang Bei-Jian, Ding Hong, Mao Feng
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, 200032, China,
Abdom Imaging. 2014 Feb;39(1):168-74. doi: 10.1007/s00261-013-0051-3.
The aim of this study was to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of hepatic inflammatory pseudotumor (IPT).
We retrospectively reviewed 36 cases of histopathologically diagnosed IPT. Nodule enhancement appearances during the arterial, portal, and delayed phases were defined as hyperenhancement, isoenhancement, hypoenhancement, and non-enhancement compared with the surrounding liver parenchyma. Statistical analysis was performed by the one-way ANOVA and χ (2) tests.
Among total 36 cases, 7 nodules were absent of contrast enhancement during all three phrases on CEUS. Twenty-nine nodules appeared different forms of enhancement in arterial phase. Diffuse homogeneous hyperenhancement, diffuse heterogeneous hyperenhancement, peripheral rim-like enhancement, and diffuse iso-enhancement were found in 10, 12, 5, and 2 of the nodules, respectively. Twenty-five nodules showed hypoenhancement in portal and delayed phases. Four nodules showed contrast washed out synchronously with normal liver parenchyma. The median time to enhancement, median time to peak, and median time to wash out of the nodules were 17 s (range 11-28 s), 23 s (range 14-42 s), and 45 s (range 23-100 s), respectively. No statistical significant differences were found in the above parameters of nodule enhancement and proportion of enhancement patterns when dividing the nodules into subgroups by nodule size.
IPT displays a variety of enhancement patterns due to pathological changes in the course of disease progression. Some characteristics on CEUS may be helpful in the differential diagnosis of IPT.
本研究旨在评估超声造影（CEUS）在肝脏炎性假瘤（IPT）特征性表现方面的作用。
我们回顾性分析了36例经组织病理学确诊的IPT病例。将动脉期、门脉期和延迟期结节的增强表现定义为与周围肝实质相比的高增强、等增强、低增强和无增强。采用单因素方差分析和χ²检验进行统计学分析。
36例病例中，7个结节在CEUS的所有三个时相均无造影剂增强。29个结节在动脉期出现不同形式的增强。分别在10个、12个、5个和2个结节中发现弥漫性均匀高增强、弥漫性不均匀高增强、周边环状增强和弥漫性等增强。25个结节在门脉期和延迟期表现为低增强。4个结节与正常肝实质同步出现造影剂廓清。结节的平均增强时间、平均达峰时间和平均廓清时间分别为17秒（范围11 - 28秒）、23秒（范围14 - 42秒）和45秒（范围23 - 100秒）。按结节大小将结节分为亚组时，上述结节增强参数及增强模式比例未见统计学显著差异。
由于疾病进展过程中的病理变化，IPT表现出多种增强模式。CEUS的一些特征可能有助于IPT的鉴别诊断。
