脾脏局灶性病变的实时超声造影成像

Real-time contrast enhanced ultrasound imaging of focal splenic lesions.

作者信息

Li Wei, Liu Guangjian, Wang Wei, Wang Zhu, Huang Yang, Xu ZuoFeng, Xie XiaoYan, Lu MingDe

机构信息

Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China.

出版信息

Eur J Radiol. 2014 Apr;83(4):646-53. doi: 10.1016/j.ejrad.2014.01.011. Epub 2014 Jan 23.

DOI:10.1016/j.ejrad.2014.01.011

PMID:24529592

Abstract

OBJECTIVE

To investigate the imaging features of focal splenic lesions (FSLs) on contrast-enhanced ultrasound (CEUS).

METHODS

Thirty two patients with FSLs proved by pathology were retrospectively analyzed. CEUS was performed using intravenous bolus injection of 2.4 ml sulfur hexafluoride-filled microbubble contrast agent and real time scanning. There were hemangioma (n=7), lymphoma (n=8), true cyst (n=3), infarction (n=4), hematolymphangioma (n=2), metastasis tumor (n=2), and one for each of the following entities extramedullary hemopoiesis, hamartoma, tuberculosis, Langerhans' cell histiocytosis, inflammatory pseudotumor and myxofibrosarcoma.

RESULTS

Among 21 benign lesions, 4 infarctions and 3 cysts presented non-enhancement throughout CEUS scanning, and the other 14 lesions displayed various enhancement levels with 6 (42.9%) hyper-enhancement, 2 (14.3%) iso-enhancement and 6 (42.9%) hypo-enhancement in arterial phase and 11 (78.6%) hypo-enhancement, 1 (7.1%) iso-enhancement and 2 (14.3%) hyper-enhancement in late phase, respectively. The enhancement pattern included 9 (64.3%) homogeneous, 4 (28.6%) heterogeneous and 1 (7.1%) rim-like enhancement. As for the malignant FSLs, all the lesions became completely or extensively hypo-enhancement during the late phase no matter their vascularity during arterial phase.

CONCLUSIONS

The CEUS features reported in this series may enrich the knowledge for CEUS characterization of FSLs.

摘要

目的

探讨超声造影（CEUS）对脾脏局灶性病变（FSLs）的影像学特征。

方法

回顾性分析32例经病理证实的FSLs患者。采用静脉团注2.4 ml六氟化硫微泡造影剂并实时扫描进行CEUS检查。其中有血管瘤（n = 7）、淋巴瘤（n = 8）、真性囊肿（n = 3）、梗死（n = 4）、血液淋巴管瘤（n = 2）、转移瘤（n = 2），以及以下各1例：髓外造血、错构瘤、结核、朗格汉斯细胞组织细胞增多症、炎性假瘤和黏液纤维肉瘤。

结果

21例良性病变中，4例梗死和3例囊肿在整个CEUS扫描过程中均无增强，其他14例病变表现出不同程度的增强，动脉期有6例（42.9%）高增强、2例（14.3%）等增强和6例（42.9%）低增强，延迟期分别有11例（78.6%）低增强、1例（7.1%）等增强和2例（14.3%）高增强。增强模式包括9例（64.3%）均匀增强、4例（28.6%）不均匀增强和1例（7.1%）边缘增强。对于恶性FSLs，无论动脉期血管情况如何，所有病变在延迟期均呈完全或广泛低增强。