超聲造影與彩色多普勒超聲診斷海綿狀肝血管瘤的影像學(xué)表現(xiàn)及其價值分析
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Imaging manifestations and value analysis of contrast-enhanced ultrasound and color Dopplerultrasound in thediagnosisofcavernoushepatic hemangiomaSunFeifei.
【Abstract】ObjectiveTo explore the imaging manifestationsand value of contrast-enhanced ultrasound （CEUS） and color Doppler ultrasound（CDFI） in thediagnosis of cavernous hepatic hemangioma （HCH）.MethodsA total of 78 suspected cases with HCHwho visitedour hospital from January2O22 to March 2O24 were selectedand underwent CEUS and CDFI examinations.The diagnostic eficacy of CEUSand CDFIfor HCH and their consistency with the pathological diagnosis were analyzed based on thepathological examination results.ResultsAsaresult of the pathological examination， 54 suspected patients （69 % ）wereultimately confirmed to have HCH，with 61 lesions.32 cases （ 41% ）withHCH were detected byCDFI，with38lesions（ 62% ），ofwhich28 showed high echogenicity（ 46% ） and were considered as hemangiomas. Seven lesions （9 % ）were misdiagnosed，and the pathological examination showed that1case （ 1% ）wasascites，6cases（ 8% ）were primary liver cancer，and 22 cases 28% were missed.A total of 48 cases （ 62% ）with HCH were detected by CEUS，with 56 lesions （92 % ）.Amongthem，32 lesions（ 52% ）were completely filled from the periphery to the center，and 22 lesions （ 39% ）showed an overall enhanced state.Two cases （ 3% ）were misdiagnosed，and the lesions showed hypoechogenicity，all of which were misdiagnosedas hepatocelllaradenomas. Six cases （8 % ） were missed.The accuracy of CEUS combined with CDFI in diagnosing HCH was higher than that of single detection，andthesensitivity，positive predictive value，specificity，andnegativepredictivevalue wereallhigher than CDFI （ P< 0.05）.The consistency between CDFI diagnosis of HCH and pathological diagnosis was generally good （Kappa value=0.256，P=0.014），whiletheconsistencywith CEUS diagnosis was stillacceptable （Kappa value=0.673， P< （204號 0.001）.Theconsistencywith combined diagnosis was good （Kappa value=0.940，P<0.Ool）.ConclusionCEUS combined with CDFIdiagnosisof HCH has high accuracy，and the diagnosticresultsare consistent with pathological examination，which is conducive to reducing misdiagnosisand missed diagnosis and guiding clinical treatment.
[Key words】 Cavernous hepatic hemangioma; Contrast-enhanced ultrasound;Color Doppler ultrasound; Imaging manifestations
肝血管瘤發(fā)病機制復(fù)雜，多與血管畸形有關(guān)，其會改變血流動力學(xué)，并損傷血管壁，使得血管內(nèi)皮生長因子表達增加，促進內(nèi)皮細胞增生進而誘發(fā)疾病，其中海綿狀肝血管瘤（HCH）發(fā)病率約占其總發(fā)病率的 60%[1，2] 。（剩余6281字）