超声造影在肝内胆管细胞癌诊断中的应用价值。

Contribution of contrast-enhanced sonography in the detection of intrahepatic cholangiocarcinoma.

机构信息

Department of Ultrasound, Zhongshan Hospital, Fudan University, 180 Feng-lin Rd, 200032 Shanghai, China.

出版信息

J Ultrasound Med. 2014 Feb;33(2):215-20. doi: 10.7863/ultra.33.2.215.

DOI:10.7863/ultra.33.2.215

PMID:24449723

Abstract

OBJECTIVES

The purpose of this study was to evaluate the contribution of contrast-enhanced sonography in the diagnosis of intrahepatic cholangiocarcinoma up to 3 cm and analyze its dynamic enhancement patterns.

METHODS

Forty-five patients (29 male and 16 female; mean age ± SD, 61.3 ± 10.7 years; range, 38-79 years) with a preliminary diagnosis of intrahepatic cholangiocarcinoma by contrast-enhanced sonography were retrospectively analyzed. For each nodule, the enhancement pattern, level, and dynamic change during the arterial, portal, and late phases after the injection of a sulfur hexafluoride microbubble contrast agent were evaluated.

RESULTS

Among the 35 patients with a histopathologic diagnosis of intrahepatic cholangiocarcinoma, 18 nodules showed hyperenhancement during the arterial phase, and 17 showed hypoenhancement. Heterogeneous, peripheral, and partial enhancement were found in 24, 8, and 2 nodules, respectively. However, only 1 nodule showed homogeneous enhancement. During the portal phase, 34 nodules showed hypoenhancement, and 1 showed isoenhancement. Hypoenhancement during the late phase was observed in all cases. Ten patients had a misdiagnosis of intrahepatic cholangiocarcinoma.

CONCLUSIONS

Intrahepatic cholangiocarcinoma up to 3 cm may display a variety of arterial enhancement patterns on contrast-enhanced sonography. However, some other nodules may manifest findings similar to those of intrahepatic cholangiocarcinoma.

摘要

目的

本研究旨在评估对比增强超声在诊断最大直径 3cm 以内肝内胆管细胞癌中的作用，并分析其动态增强模式。

方法

回顾性分析了 45 例经对比增强超声初步诊断为肝内胆管细胞癌的患者（男 29 例，女 16 例；平均年龄±标准差，61.3±10.7 岁；范围，38-79 岁）。对于每个结节，评估了注射六氟化硫微泡造影剂后动脉期、门静脉期和晚期的增强模式、增强水平和动态变化。

结果

在 35 例经组织病理学诊断为肝内胆管细胞癌的患者中，18 个结节在动脉期呈高增强，17 个呈低增强。24 个结节呈不均匀、周边和部分增强，8 个结节呈均匀增强，2 个结节呈均匀增强。然而，只有 1 个结节呈均匀增强。在门静脉期，34 个结节呈低增强，1 个结节呈等增强。所有病例在晚期均呈低增强。10 例患者误诊为肝内胆管细胞癌。