超声造影与彩色多普勒超声诊断海绵状肝血管瘤的影像学表现及其价值分析

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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号 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

肝血管瘤发病机制复杂，多与血管畸形有关，其会改变血流动力学，并损伤血管壁，使得血管内皮生长因子表达增加，促进内皮细胞增生进而诱发疾病，其中海绵状肝血管瘤（HCH）发病率约占其总发病率的 60%[1，2] 。（剩余6281字）