Effect Of Valsalva Maneuver On Echogenic Changes Of Hepatic Hemangioma In Ultrasound

Objective: To explore the changes of echogenic response of hepatic hemangioma in Valsalva Maneuver(VM),and to observe the characteristic images of hepatic hemangioma,which provides a meaningful reference for the diagnosis of hepatic hemangioma.Methods: Eighty patients who were selected from the first affiliated hospital of Shihezi University Medical College from 2016-06 to 2018-06 were confirmed by Computed Tomography(CT)or Magnetic Resonance Imaging(MRI)imaging.Hepatic hemangioma,and a single hepatic hemangioma,with an average follow-up of more than 1 year.There were 39 males and 41 females;aged 18-85 years,mean(45.94±13.51)years old;incidence: 21 cases of left hepatic lobe,59 cases of right hepatic lobe;maximum long diameter of 0.9~7.5cm,mean(2.63± 1.35)cm;38 cases of Body Mass Index(BMI)18.5~24,42 cases of BMI>24;58 cases of normal liver background,18 cases of patients with fatty liver background,patients with cirrhosis background There were 4 cases;all patients had no obvious clinical symptoms.According to the 2016 European Society of Liver Diseases Clinical Practice Guidelines,typical hepatic hemangioma ultrasound features: maximum long diameter <3cm,high echo,uniform echo,clear boundary,round-like;atypical hepatic hemangioma ultrasound features: in addition to typical hepatic vessels Sound image performance outside the ultrasound features of the tumor.The echo image of the lesion obtained before the VM and the echo image of the lesion after the completion of the VM were examined and analyzed by a skilled and experienced sonographer.Results: After VM,96%(77/80)of hepatic hemangioma echoes changed in hepatic hemangioma,and 4%(3/80)hepatic hemangioma echo did not change significantly.In the 80 cases of hepatic hemangioma,15%(12/80)were typical hepatic hemangioma,and 85%(68/80)were atypical hepatic hemangioma.After VM,the echogenic changes of 12 typical hepatic hemangioma showed: 92%(11/12)of hepatic hemangioma echoes showed echo enhancement;1%(1/12)hepatic hemangioma echo appeared The internal echo height and contrast increased;42%(5/12)of the hepatic hemangioma echoes showed a clearer edge;17%(2/12)of the hepatic hemangioma echoes showed a posterior echo enhancement.After VM,the echogenic changes of 68 cases of atypical hepatic hemangioma: 21%(14/68)of hepatic hemangioma echoes showed an overall increase in echo;68%(46/68)of hepatic hemangioma echoes appeared internally Echo echo height increased;69%(47/68)hepatic hemangioma echoes appeared sharper;3%(2/68)hepatic hemangioma echo showed posterior echo enhancement;4%(3/68)of hepatic hemangioma echoes did not change significantly.In addition,after VM,the echogenic changes of hepatic hemangioma in 18 cases of fatty liver showed: 28%(5/18)of hepatic hemangioma echoes showed an overall increase in echo;61%(11/18)Hepatic hemangioma echoes showed an increase in internal echo height;50%(9/18)of hepatic hemangioma echoes showed a clearer edge;6%(1/18)of hepatic hemangioma echoes appeared The rear echo is enhanced.After VM,the echogenic changes of hepatic hemangioma in 4 cases of cirrhosis: 25%(1/4)of the hepatic hemangioma echoes have a clearer edge;75%(3/4)of the liver There was no significant change in the echo of hemangioma.Conclusion: In the ultrasound examination of the liver in the VM: The hepatic hemangioma showed an overall increase in echo,the internal echo height increased contrast,the boundary was clearer,and the posterior echo enhanced;In the background of fatty liver,the hepatic hemangioma has an overall enhancement of echo,the internal echo is increased,the boundary is clearer,and the posterior echo is enhanced.In the background of liver cirrhosis,the echo of hepatic hemangioma has clearer or no obvious changes.Changes can increase the accuracy of VM diagnosis of hepatic hemangioma in ultrasound.