Department of ultrasound, Drumtower Hospital, Medical College of Nanjing University, Nanjing, China.
Department of ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
Med Ultrason. 2021 Feb 18;23(1):15-21. doi: 10.11152/mu-2542. Epub 2020 Aug 18.
The aim of this study is to investigate whether the use of contrast enhanced ultrasound (CEUS) can improve the differential diagnostic performance between hepatic inflammatory pseudotumor (HIPT) and other malignant tumors.
Forty-four patients with histological proven HIPTs were included in this retrospective study. The features of conventional ultrasound (US) and CEUS were evaluated.
Three kinds of enhanced pattern can be seen in the 44 nodules including homogeneous (n=18, 41%), heterogeneous (n=16, 36%) and rim-like enhancement (n=10, 23%). All of the nodules showed hypo-enhancement during the portal and delayed phase. The dominant nodules (n=29, 66%) presented wash-out within 60 s after contrast injection. Quick wash-in and wash-out was seen in 18 nodules (41%). Eighteen nodules (41%) were correctly diagnosed as HIPT, whereas the remaining 26 cases were misdiagnosed as malignancies (n=20, 45%) or with an uncertain diagnosis (n=6, 14%).
CEUS was not enough to differentiate HIPT from hepatic malignancies, especially intrahepatic cholangiocarcinoma and liver metastasis. However, some CEUS imaging characteristics may be helpful for HIPT diagnosis.
本研究旨在探讨对比增强超声（CEUS）是否能提高肝炎性假瘤（HIPT）与其他恶性肿瘤的鉴别诊断性能。
回顾性纳入 44 例经组织学证实的 HIPT 患者，评估其常规超声（US）和 CEUS 的特征。
44 个结节中可见 3 种增强模式，包括均匀增强（n=18，41%）、不均匀增强（n=16，36%）和边缘样增强（n=10，23%）。所有结节在门静脉期和延迟期均呈低增强。主要结节（n=29，66%）在造影剂注射后 60s 内出现洗脱。18 个结节（41%）呈快速增强和快速洗脱。18 个结节（41%）被正确诊断为 HIPT，而其余 26 个病例被误诊为恶性肿瘤（n=20，45%）或诊断不确定（n=6，14%）。
CEUS 不足以区分 HIPT 与肝恶性肿瘤，尤其是肝内胆管细胞癌和肝转移瘤。然而，一些 CEUS 成像特征可能有助于 HIPT 的诊断。
