The Value Of Contrast-enhanced Ultrasonography In The Diagnosis And Differential Diagnosis Of Complex Congenital Intrahepatic Cholangiectasis

Objective:To evaluate the value of ultrasonography in the diagnosis and differential diagnosis of congenital intrahepatic cholangiectasis(CD)with atypical or complicated ultrasonography.Methods:From 2014 to 2019,CD was diagnosed by Surgical pathology or biopsy(9 cases of type ? and 27 cases of type ?).At the same time,40 cases of liver abscess(LA)and 40 cases of tumor group(including hcc25 and icc15)were included.The clinical characteristics,US and CEUS were compared and analyzed.Results:The clinical manifestations of CD were mainly found in women,accounting for 66.67%(24/36),with an average age of 23 years(age range:1-72 years).The clinical manifestations of CD were nonspecific and related to its complications.In CD group,US all showed multifocal/segmental dilatation of intrahepatic bile duct.The image features "cystic tail sign" also were detected sonographically In US report,CD10 cases(10/36,46.3%)were definitely diagnosed,16 cases were suspected and 10 cases were not diagnosed.The accuracy of diagnosis was 46.3%.(1)The edge of the lesion:the arterial phase-portal phase-parenchymal phase 3 and other enhancements are 27.8%(10/36),the third phase high enhancement is 38.9%(14/36),and the hyper-iso-iso enhancement is 13.9%(5/36),high-equivalent-low enhancement 11.1%(4/36);(2)the internal parenchyma of the lesions are all iso-enhancement,and there is no enhancement in the third phase Area.29 cases(29/36,80.6%)of CD were clearly diagnosed in the CEUS examination report.Five cases were suspected of the disease and 2 cases were not diagnosed.The diagnostic accuracy rate was 80.6%.Characteristics of CEUS in LA group:CEUS showed rapid and high enhancement of the edge of the lesion at 100%(40/40)in the arterial phase,and rapid regression in the portal phase-delay phase showed hypo-enhancement.The characteristics of CEUS in the tumor group:97.5%(39/40)of the 40 lesions have rapid and high arterial phase enhancement,and 2.5%(1/40)third phase enhancementConclusion:US characteristics The hepatic bile duct is segmental dilated in varying degrees.CEUS can accurately evaluate CD lesions.Us and CEUS can accurately evaluate the common complications of CD,...