| 脂肪肝对超声造影诊断肝内炎性假瘤的影响* |
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| 引用本文： | 黄玮,范智慧,陈磊,王丹.脂肪肝对超声造影诊断肝内炎性假瘤的影响*[J].实用肝脏病杂志,2022,25(6):897-900. |
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| 作者姓名： | 黄玮 范智慧 陈磊 王丹 |
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| 作者单位： | 063000 河北省唐山市 华北理工大学附属开滦总医院超声医学科 |
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| 基金项目： | *河北省卫生健康委员会医学科学研究计划项目(编号:20210402) |
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| 摘 要： | 目的 研究脂肪肝对超声造影诊断肝脏炎性假瘤(IPL)的影响。方法 2016年1月～2021年1月华北理工大学附属开滦总医院诊治的IPL患者28例,其中伴有脂肪肝者12例,正常肝内IPL患者16例。所有患者均接受超声造影检查,比较两组血供状态、超声造影增强模式和超声造影定量参数的异同。结果 伴脂肪肝的IPL病灶动脉供血1例(8.3%)、静脉供血11例(91.7%)、富血供3例(25.0%)、乏血供9例(75.0%),IPL病灶动脉供血7例(43.8%)、静脉供血9例(56.3%)、富血供5例(31.3%)、乏血供11例(68.8%),两组供血类型存在显著性差异(P<0.05),而血供丰富程度无显著性差异(P＞0.05);伴脂肪肝病灶呈无明显增强型1例、快速廓清型5例、等增强型3例和低增强型3例,IPL病灶呈无明显增强型2例、快速廓清型5例、等增强型7例和低增强型2例,两组超声造影增强模式无显著差异(P=0.661);伴脂肪肝病灶造影剂到达时间为(8.9±1.3)s,显著慢于IPL病灶【((8.0±0.9)s,P<0.05】,峰值强度为(53.2±7.8)dB,显著弱于IPL病灶【((61.1±9.7)dB,P<0.05】,而两组达峰时间、曲线尖度和曲线下面积无显著性差异(P＞0.05)。结论 与正常肝背景下的IPL病灶比,合并脂肪肝的IPL病灶以静脉供血为主,其造影剂的到达时间较长,而峰值强度降低,在临床诊断时需要认真地甄别。
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| 关 键 词： | 肝脏炎性假瘤 脂肪肝 超声造影 血供 诊断 |
| 收稿时间： | 2022-02-18 |
Impact of fatty liver on the diagnosis of contrast-enhanced ultrasound in patients with inflammatory pseudotumor of liver |
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| Huang Wei,Fan Zhihui,Chen Lei,et al..Impact of fatty liver on the diagnosis of contrast-enhanced ultrasound in patients with inflammatory pseudotumor of liver[J].Journal of Clinical Hepatology,2022,25(6):897-900. |
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| Authors: | Huang Wei Fan Zhihui Chen Lei |
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| Affiliation: | Department of Ultrasound, Kailuan General Hospital Affiliated to North China University of Science and Technology,Tangshan 063000,Hebei Province, China |
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| Abstract: | Objective The purpose of this study was to investigate the impact of fatty liver on the diagnosis of contrast-enhanced ultrasound (CEUS) in patients with inflammatory pseudotumor of liver (IPL). Methods 28 patients with IPL were encountered in Kailuan General Hospital, North China University of Science and Technology between January 2016 and January 2021, and out of them, 12 patients with underlying fatty liver. The diagnosis was made by fine needle aspiration biopsies or post-operational histopathologic examination. All patients underwent CEUS, and the blood supply status, contrast-enhanced modes and quantitative parameters were compared between the two groups. Results In patients with IPL and underlying fatty liver, there were 1 cases (8.3%) with arterial blood supply, 11 cases (91.7%) with venous blood supply, 3 cases (25.0%) presenting with rich blood supply, and 9 cases (75.0%) with poor blood supply, while in patients with IPL and normal liver, there were 7 cases (43.8%) with arterial blood supply, 9 cases (56.3%, P<0.05) with venous blood supply, 5 cases (31.3%) presenting with rich blood supply and 11 cases(68.8)with poor blood supply (P>0.05); there were no significant differences in blood supply type and blood supply richness between the two groups (P>0.05); In patients with fatty liver, there were no significant enhancement of foci under CEUS in 1 cases, enhancement with rapid clearance in 5 cases, equal enhancement in 3 cases, and low enhancement in 3 cases, while in patients with IPL, there were no significant enhancement in 2 cases, enhancement with rapid clearance in 5 cases, equal enhancement in 7 cases, and low enhancement in 2 cases, not significantly different between the two groups in contrast enhancement mode ( P=0.661); in patients with IPL and fatty liver, the contrast agent arrival time was (8.9±1.3) s, significantly slower than ((8.0±0.9)s, P<0.05], and the peak intensity was (53.2±7.8)dB, significantly weaker than ((61.1±9.7)dB, P<0.05] in patients with IPL, while there were no significant differences as respect to the peak time, the curve sharpness and the area under curve between the two groups (P> 0.05). Conclusion The IPL foci in patients with fatty liver are mainly having venous blood supply, and the underlying fatty liver might interfere with the imaging diagnosis, which should be carefully identified. |
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| Keywords: | Inflammatory pseudotumor of liver Fatty liver Contrast-enhanced ultrasound Blood supply Diagnosis |
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