Zhang H, Liu Z-H, Zhu H, Han Y, Liu J, Deng L-Q
Department of Ultrasonography, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Clinical Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Eur Rev Med Pharmacol Sci. 2016 May;20(10):1954-60.
Contrast-Enhanced Ultrasound (CEUS) has been introduced as a promising imaging technique for diagnosis of hepatic alveolar echinococcosis (HAE). But the correlation between the image features and the underlying complex pathology of HAE has not been fully understood. In this study, we reviewed CEUS and pathological images of 31 lesions in 24 patients with HAE from Aba Tibetan Qiang Autonomous Prefecture, an epidemic area in China.
24 patients who received CEUS examination for suspicion of HAE and with pathologically confirmed HAE were retrospectively reviewed. Parasitic lesions obtained from surgery were sectioned and stained with hematoxylin and eosin (HE).
US examination showed that the 12 lesions were hypoechoic and 19 lesions were hyperechoic. The hypoechoic images of HAE quite resemble the images of hepatocellular carcinoma and hemangioma. For the CEUS images of lesions ≥3 cm, 9 lesions (9/25, 36%) were hypoechoic with mixed content without circular rim enhancement; 16 lesions (16/25, 64%) had circular rim enhancement. All the lesions < 3 cm (n=6) were with circular rim enhancement and non-enhancement internal area. Pathological examination showed that the cysts are surrounded by an inner necrotic zone and peripheral granulomatous and fibrous tissues.
CEUS images of large HAE lesions are more complex than that of the small lesions. Large HAE lesions can be hypoechoic with mixed content with or without circular rim enhancement, and no internal area enhancement with circular rim enhancement. The small lesions are more likely to show circular rim enhancement and non-enhancement internal area.
超声造影（CEUS）已被引入作为诊断肝泡型包虫病（HAE）的一种有前景的成像技术。但HAE的图像特征与潜在复杂病理之间的相关性尚未完全明确。在本研究中，我们回顾了来自中国流行区阿坝藏族羌族自治州的24例HAE患者31个病灶的CEUS和病理图像。
回顾性分析24例因疑似HAE接受CEUS检查且病理确诊为HAE的患者。手术获取的寄生病灶进行切片，并用苏木精和伊红（HE）染色。
超声检查显示，12个病灶为低回声，19个病灶为高回声。HAE的低回声图像与肝细胞癌和血管瘤的图像非常相似。对于直径≥3 cm的病灶的CEUS图像，9个病灶（9/25，36%）为低回声，内容物混合，无环状边缘强化；16个病灶（16/25，64%）有环状边缘强化。所有<3 cm的病灶（n = 6）均有环状边缘强化且内部区域无强化。病理检查显示，囊肿被内部坏死区以及周围的肉芽肿和纤维组织所包围。
大的HAE病灶的CEUS图像比小病灶更复杂。大的HAE病灶可为低回声，内容物混合，有或无环状边缘强化，且环状边缘强化时内部区域无强化。小病灶更易表现为环状边缘强化且内部区域无强化。
