Bartolotta Tommaso Vincenzo, Randazzo Angelo, Bruno Eleonora, Taibbi Adele
Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy.
World J Radiol. 2022 Apr 28;14(4):70-81. doi: 10.4329/wjr.v14.i4.70.
Contrast-enhanced ultrasound (CEUS) represents a great innovation for the evaluation of focal liver lesions (FLLs). The main advantage of CEUS is the real-time imaging examination and the very low toxicity in patients with renal failure. Liver cirrhosis has been recognized as a major risk factor for the onset of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). HCC in liver cirrhosis develops as the last step of a complex that leads to the gradual transformation from regenerative nodule through dysplastic nodule to HCC. In patients with liver cirrhosis, a surveillance program is recommended consisting of ultrasound (US) for detecting small focal lesions. A wide spectrum of benign and malignant lesions other than HCC may be found in the cirrhotic liver and their differentiation is important to avoid errors in staging diseases that may preclude potentially curative therapies. Several published studies have explored the value of CEUS in liver cirrhosis and they have been shown to have excellent diagnostic and prognostic performances for the evaluation of non-invasive and efficient diagnosis of FLLs in patients at high risk for liver malignancies. The purpose of this article is to describe and discuss CEUS imaging findings of FLLs including HCC and ICC, all of which occur in cirrhotic livers with varying prevalence.
超声造影（CEUS）是评估肝脏局灶性病变（FLLs）的一项重大创新。CEUS的主要优势在于实时成像检查以及对肾衰竭患者的极低毒性。肝硬化已被公认为肝细胞癌（HCC）和肝内胆管癌（ICC）发病的主要危险因素。肝硬化中的HCC是一个复杂过程的最后阶段，该过程导致从再生结节逐步转变为发育异常结节，最终发展为HCC。对于肝硬化患者，建议采用包括超声（US）在内的监测方案来检测小的局灶性病变。在肝硬化肝脏中可能会发现除HCC之外的多种良性和恶性病变，区分它们对于避免疾病分期错误很重要，因为分期错误可能会排除潜在的治愈性治疗方法。多项已发表的研究探讨了CEUS在肝硬化中的价值，结果表明其在评估肝脏恶性肿瘤高危患者的FLLs时具有出色的诊断和预后性能，可实现非侵入性且高效的诊断。本文旨在描述和讨论FLLs（包括HCC和ICC）的CEUS成像表现，所有这些病变在肝硬化肝脏中均有不同程度的发生率。
