Pschierer K, Grothues D, Rennert J, da Silva N Platz Batista, Schreyer A G, Melter M, Stroszczysnski C, Jung E M
Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
Department of Paediatrics and Juvenile Medicine (KUNO), University Hospital Regensburg, Franz-Josef-Strauss-Allee, Regensburg, Germany.
Clin Hemorheol Microcirc. 2015;61(2):333-45. doi: 10.3233/CH-152003.
Comparison of the diagnostic findings of MRI, CT and CEUS in children with benign and malignant and portal venous anomalies of the liver.
MATERIALS/METHODS: Retrospective analysis of the diagnostic findings of CEUS, MRI and CT scans in 56 children (age 0-17 years) with a total of 60 benign and malignant liver lesions and anomalies of the portal vein/perfusion. All patients underwent CEUS using sulphur hexafluoride microbubbles and a multi-frequency probe (1-5 MHz, 6-9 MHz). Cine-loops were stored up to 3 minutes. MRI was performed in 38 lesions. CT was performed in 8 lesions.
Out of the 56 patients 49 liver lesions (48 benign, 1 malignant), 9 anomalies of the portal vein/perfusion and 2 of the biliary system were detected. 16/49 lesions were analyzed histopathologically. Using CEUS, the characterization of the lesions was possible in 45 out of 49 cases. In 32 cases, CEUS provided the exact diagnosis. Only two benign lesions were falsely categorized as malignant.Findings of MRI and CEUS were concordant in 84% of cases (n = 32/38). CEUS considered 1 benign lesion to be malignant. 2 lesions were not detectable and in 3 lesions no definite diagnosis was established using MRI.Findings of CT and CEUS were concordant in 5 of 8 cases. In 21 lesions CEUS as the only imaging modality was found to be sufficient for diagnostics.
Despite the restricted indications for using CEUS in children, it offers a high diagnostic detection rate (93%) for characterization of liver lesions and portal vein anomalies.
比较磁共振成像（MRI）、计算机断层扫描（CT）和对比增强超声（CEUS）对儿童肝脏良恶性病变及门静脉异常的诊断结果。
材料/方法：回顾性分析56例年龄在0至17岁的儿童的CEUS、MRI和CT扫描诊断结果，这些儿童共有60处肝脏良恶性病变以及门静脉/灌注异常。所有患者均使用六氟化硫微泡和多频率探头（1 - 5MHz，6 - 9MHz）进行CEUS检查。动态循环图像存储长达3分钟。对38处病变进行了MRI检查。对8处病变进行了CT检查。
在56例患者中，检测到49处肝脏病变（48处良性，1处恶性）、9处门静脉/灌注异常以及2处胆道系统异常。对49处病变中的16处进行了组织病理学分析。使用CEUS，49例中的45例能够对病变进行特征描述。在32例中，CEUS给出了准确诊断。仅2处良性病变被错误分类为恶性。MRI和CEUS的结果在84%的病例（n = 32/38）中一致。CEUS将1处良性病变视为恶性。2处病变未被检测到，3处病变使用MRI未明确诊断。CT和CEUS的结果在8例中的5例中一致。在21处病变中，发现CEUS作为唯一的成像方式足以进行诊断。
尽管CEUS在儿童中的应用指征有限，但它对肝脏病变和门静脉异常的特征描述具有较高的诊断检出率（93%）。
