| Objective: Although gray-scale ultrasound screening as a focal liverlesions preferred imaging methods, but its diagnostic sensitivity of focal liverlesions was much lower than contrast-enhanced computed tomography andcontrast-enhanced MRI,with the development of science and technology, theemergence of CEUS, The diagnostic value of ultrasonography in benign andmalignant focal liver lesions was also rising, CEUS in the diagnosis of focalliver lesions sensitivity could even be compared with contrast-enhancedcomputed tomography and contrast-enhanced MRI. The image features ofCEUS in focal inflammatory lesions of the liver exhibits diversity, which hadmany similarities with Malignant focal liver lesions, so the diagnosis of hepaticfocal inflammatory lesions had been difficult, in this study, by combining thecharacteristics of gray-scale ultrasound and CEUS images, to explore thecombination of both in the value of clinical diagnosis of hepatic focalinflammatory lesions.Methods: A retrospective analysis from November2010to May2013inour hospital received a liver ultrasound imaging of patient data47cases of focal inflammatory lesions (which liver abscess in19cases,27cases of cholangitislesions, one case of liver tuberculosis). Single lesion in41cases, six cases ofmultiple lesions, multiple lesions in patients with lesions in the selectedmaximum target lesions,47patients enrolled were47lesions analyzed. Lesiondiameter1.5~9.1cm, the average (3.2±1.9) cm. After puncture biopsy orpuncture fluid laboratory tests confirmed23cases, clinically confirmed by acomprehensive analysis of24cases. Clinical symptoms: only nine patients hadabdominal pain and fever, and the remaining cases were accidentally discoveredultrasound lesions. Laboratory tests: blood leukocytosis in10patients, sevencases of hepatitis B virus surface antigen-positive patients, all patients withhepatitis C virus surface antigen and alpha-fetoprotein were negative. usingGELOGE9color Doppler ultrasound, ultrasound contrast agent was Braccoproduced Sonovue. Routine ultrasound examination before ultrasound contrast,observed target lesions and liver tissue, records the number, the size, location,shape, border, internal echo and intralesional blood supply, with or withoutmass effect of the lesion,and so on. After determining the target lesionmaximum scanning section, switched to contrast mode, and set the mechanicalindex of0.15, while the injection of contrast agents started the timer, continuousreal-time observation of the lesion and the surrounding liver tissue contrastimaging5min, the contrast of the whole process of moving image storage theinstrument hard disk. Two doctors who had more than three years experiencein ultrasound contrast and didn’t know the results of the pathologicalfinds,analyzed47inflammatory lesions of the liver ultrasound and ultrasoundcontrast grayscale image features and the results were compared withpathological.Results: The characteristics of47inflammatory lesions on gray-scale Ultrasound were: regular and irregular in shape in15and32, distinguishableboundary and undistinguishable boundary in15and32, mixed nodules andunmixed nodules in10and37, space occupying effect in15(4≤3cm,11个＞3cm) and no space occupying effect in32(27≤3cm,5个＞3cm). Thecharacteristics on CEUS were: The surrounding ring hyperenhancement orisoenhancement in the arterial phase were30, and no internal enhancement, inthe late phase surrounding ring isoenhancement were24,surrounding ringhypo-enhancement were6;irregular hyper-enhancement or isoenhancement were17in arterial phase,and were hypo-enhancement in the late phase; internalseparation enhanced were14; the liver tissue surrounding the lesions irregularflakes of hyperenhancement in the arterial phase were38,no abnormalenhancement were9.The characteristics of23inflammatory lesions which werehypoenhancement in the late phase on gray-scale ultrasound andcontrast-enhanced ultrasound: regular and irregular in shape in6and17,distinguishable boundary and undistinguishable boundary in6and17, mixednodules and unmixed nodules in6and17, space occupying effect and no spaceoccupying effect in6and17,surrounding ring hyperenhancement in the arterialphase were6, irregular hyperenhancement17; internal separation enhanced8;liver segment enhancement7.Conclusion: Each focal inflammatory lesions of the liver had a certaingray-scale ultrasound and contrast-enhanced ultrasound image features, thecontrast and grayscale ultrasound combined with ultrasound helped to improvethe accuracy of diagnosis of focal inflammatory lesions of the liver. |
PDF Full Text Request