超声造影在病毒性肝炎背景下对肝脏占位性病变的诊断价值

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1、超声造影在病毒性肝炎背景下对肝脏占位性病变的诊断价王世鹏王存德刘军德张亚红叶君君王秀梅，甘肃省武威肿瘤医院超声科733000【摘要】病毒性肝炎患者肝纤维化程度不同，造影剂在病灶的显影时相与正常肝组织显影时相产生差别，以常规造影鉴别模式可能在时间把握上存在一定误差。本研究意在探讨在病毒性肝炎背景下超声造影对肝脏古位的良恶性鉴别价值，以提高临床对疾病的诊断需求。方法：选取2013年5月-2016年2月间，我科常规彩超检查不能完全明确性质的具有病毒性肝炎背景并发肝脏占位的患者，接受超声造影检查的肝脏占位的患者共95例。(其屮男

2、61例，女34例，年龄最小者19岁，最大者79岁)。结果：本组超声造影检查人次共95例，无一发生明显不良反应。对常规检查发现肝脏占位不能确定性质结节共107个，以超声造影检查后，定性为良性病变的79例，定性为恶性病变的27例。另外1例肝外病变被误诊为肝内占位性病变。结论：在具有病毒性肝炎背景合并肝脏占位的患者屮，由于肝脏纤维化造成肝A微环境改变，影响丫占位的血供情况，而造影剂仍旧可以清楚显示古位的血流进入时间及灌注模式，提高了对肝脏古位性病变良恶性的鉴别诊断。【关键词】超声造影，病毒性肝炎，肝脏占位【中图分类号】R445

3、.1【文献标识码】A【文章编号】2096-0867(2016)11-218-02Diagnosticvalueofcontrast-enhancedultrasoundinthediagnosisofliverspaceoccupyinglesionsinthebackgroundofviralhepatitisWangShipeng'WangCunde'LiuJunde,ZhangYahong,YeJunjun,WangXiumeiABSTRACTObjective:Thelevelofvirushepatitispa

4、tientswithhepaticfibrosisaredifferent,contrastagentinthelesionsofthedevelopingphaseandnormallivertissueinthedevelopingphasedifference,withconventionaldiagnosisanddifferentialmodemayexistcertainerrorsintiming.Thepurposeofthisstudywastoinvestigatethevalueofcontrast

5、-enhancedultrasoundinthediagnosisofbenignandmalignantliverlesionsinpatientswithviralhepatitis.Methods:Selectpatientsbetween2013.5-2016.2,routineultrasoundexaminationcannotentirelycleardiagnosispropertieswithviralhepatitiscomplicatedwithliverspaceoccupyinglesionsi

6、npatients,acceptcontrast-enhancedultrasoundofhepaticoccupiedlesionsinpatientswithtotalof95casesof.(ofwhich61weremale,34werefemale,theyoungest19yearsold,theoldestwas79yearsold).Result:lnthisgroup,95caseswereexaminedbycontrast-enhancedultrasoundwithnoobviouscomplic

7、ationoradversereaction.107casesofliverlesionswerefoundtobeunabletodeterminethenatureofthelesions,79casesofbenignlesions,27casesofmalignantlesionswereidentifiedbycontrast-enhancedultrasound.Theother1casesweremisdiagnosedashepaticspaceoccupyinglesions.Conclusion:ln

8、virushepatitiscombinedwithhepaticspaceoccupyinglesionsofpatients,duetolivermicroenvironmentchange,affectingthespaceoccupyinglesionsinthebloodsupplyasaresultofl