肝脏局灶性病变的三维超声造影研究-影像医学与核医学专业论文.docxVIP

万方数据 万方数据 目录 缩略词表····································································3 中文摘要····································································4 英文摘要····································································6 前言·········································································8 材料与方法·································································10 结果········································································12 讨论········································································24 结论········································································32 参考文献···································································33 致谢········································································36 综述········································································37 2 缩略语 英文全称 中文全称 FLL Focal Liver Lesions 肝脏局灶性病变 2D-CEUS Two-dimensional Contrast-enhanced Ultrasound 二维超声造影 3D-CEUS Three-dimensional Contrast-enhanced Ultrasound 三维超声造影 HCC Hepatocellular Carcinoma 肝细胞癌 HCH Hepatic Cavernous Hemangioma 肝血管瘤 FNH PEComa Focal Nodular Hyperplasia Perivascular Epithelioid cell tumor 局灶性结节性增生 肝血管周上皮样细胞肿瘤 PHL Primary Hepatic Lymphoma 原发性肝淋巴瘤 3 肝脏局灶性病变的三维超声造影研究 中文摘要 目的：探讨肝脏局灶性病变（FLL）的三维超声造影（3D-CEUS）声像特征及其临 床应用价值。 方法：使用 PHILIPS IU22 超声诊断仪、C5-1 凸阵探头、V6-2 三维容积探头以及 声诺维超声造影剂，经肘静脉团注法对 127 例二维超声造影（2D-CEUS）检查动 脉相早期有增强的 FLL 进行 3D-CEUS 检查。2D-CEUS 检查观察各局灶性病变的动 脉相增强方式及增强模式，3D-CEUS 检查经处理后观察病灶动脉相增强方式、病 灶内部结构，以及滋养血管数目、分布及形态等，分析两种检查方法的观察参数 对病灶性质的诊断价值。以 P＜0.05 为差异有统计学意义。 结果： 1、FLL 3D-CEUS 典型声像表现：本文 75 例肝细胞性肝癌(HCC)中有 74 例（ 98.7%） 3D-CEUS 表现为动脉相均匀/不均性整体增强（实心球样改变）,病灶滋养血管数 目随体积增大而增加，大于 1cm HCC 供养血供呈多源性向病灶内部延伸的紊乱滋 养血管；31 例肝血管瘤（HCH）均（100%）表现为动脉相环状增强或向心性增强 （空心球样改变）伴周边一侧结节样聚集规则滋养血管；11 例肝局灶性结节性 增生（FNH）有 10 例（90.9%）表现为动脉相早期病灶边缘一支滋养血管进入病 灶内部达中心呈放射状分支离心性增强；7 例肝脓肿表现为病灶内部不均匀整体 增强及该区域正常血管向病灶内部延伸，血管形态规整；2 例肝血管周上皮细胞 样肿瘤（PEC）表现为动脉相整体增强，病灶周边多源性紊乱滋养血管，但未见 向病灶内部延伸；1 例肝淋巴瘤（PHL）