Hematology, Oncology and Immunology, Philipps-University of Marburg, Germany.
Interdisciplinary Centre for Ultrasound Diagnostics, Philipps-Universitat Marburg, Germany.
Ultraschall Med. 2017 Dec;38(6):655-660. doi: 10.1055/s-0043-105577. Epub 2017 Jul 13.
Detection of mesenteric masses (MM) by 2 D ultrasound often causes a diagnostic dilemma, and histological confirmation is required for definite diagnosis. The value of contrast-enhanced ultrasound (CEUS) for the diagnosis of MMs has not been investigated before. Here, we retrospectively evaluate 2D-mode and CEUS patterns of 69 patients with histologically confirmed MMs.
Between January 2006 and January 2016, n = 69 patients were included in the study. Histopathological data, clinical data, 2D-mode ultrasound and CEUS enhancement were retrospectively analyzed.
More than half of the MMs (n = 47/69, 68 %) revealed a malignant histology. The size of the MM, inflammation markers and clinical symptoms did not correlate with the histological outcome. 2 D mode revealed n = 46 (67 %) lesions as hypoechoic, n = 14 (20 %) as hyperechoic, and n = 9 (13 %) with a complex echo pattern. Hypoechogenicity and complex echo patterns as well as regular borders of MMs were significantly associated with malignancy (p < 0.05). On CEUS, malignant MMs showed arterial hyperenhancement (n = 11/47, 23 %), isoenhancement (n = 25/47, 52 %) and hypoenhancement (n = 7/47, 15 %). The majority of malignant MMs (n = 42/47, 89 %) revealed parenchymal hypoenhancement. Benign masses revealed arterial hyperenhancement in n = 1/22 (5 %), isoenhancement in n = 8/22 (36 %), and hypoenhancement in n = 10/22 (45 %). The majority of lesions showed parenchymal hypoenhancement (n = 19/22, 86 %).
Hypoechogenicity and complex echogenicity in 2 D mode, irregular borders, and parenchymal wash-out were more often associated with malignancy. However, CEUS did not help to subclassify malignant MMs according to their histological entity.
二维超声检测肠系膜肿块（MM）常导致诊断困难，需要组织学确认才能明确诊断。对比增强超声（CEUS）在 MM 诊断中的应用尚未得到研究。在此，我们回顾性评估了 69 例经组织学证实的 MM 的 2 模式和 CEUS 模式。
2006 年 1 月至 2016 年 1 月，纳入 n=69 例患者进行研究。回顾性分析组织病理学数据、临床资料、二维超声和 CEUS 增强情况。
超过一半的 MM（n=47/69，68%）显示恶性组织学。MM 的大小、炎症标志物和临床症状与组织学结果无关。二维超声显示 n=46（67%）病变为低回声，n=14（20%）为高回声，n=9（13%）为复杂回声模式。低回声和复杂回声模式以及 MM 的规则边界与恶性肿瘤显著相关（p<0.05）。在 CEUS 上，恶性 MM 表现为动脉期高增强（n=11/47，23%）、等增强（n=25/47，52%）和低增强（n=7/47，15%）。大多数恶性 MM（n=42/47，89%）显示实质低增强。良性肿块在 n=1/22（5%）中显示动脉期高增强，在 n=8/22（36%）中显示等增强，在 n=10/22（45%）中显示低增强。大多数病变显示实质低增强（n=19/22，86%）。
二维超声的低回声和复杂回声、不规则边界和实质冲洗缺失与恶性肿瘤的关系更密切。然而，CEUS 并不能根据 MM 的组织学特征对其进行亚分类。
