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目的通过对肝血管平滑肌脂肪瘤(HAML)的二维超声、彩色多普勒血流显像特征分析并与肝血管瘤(HH)进行比较,提高对二者的鉴别能力。方法选择经病理证实的HAML患者61例(72个病灶,HAML组),其中男性13例,女性48例;年龄29~53岁,平均年龄41.67岁。同期HH患者70例(87个病灶,HH组),其中男性26例,女性44例;年龄32~56岁,平均年龄46.13岁。对两组病例的二维超声及彩色多普勒血流显像特征如病灶数目、肿块最大径、位置、边界、回声高低、回声均匀程度、网格征及血流丰富程度的差异进行分析。结果二维超声图像HAML与HH在回声均匀程度、网格征方面,差异有统计学意义(P<0.05);在病灶数目、肿块最大径、位置、边界、回声高低方面,差异无统计学意义(P>0.05)。彩色多普勒血流显像,HAML组血流0级36个(50.00%),Ⅰ级12个(16.67%),Ⅱ级20个(27.78%),Ⅲ级4个(5.56%);HH组0级69个(79.31%),Ⅰ级12个(13.79%),Ⅱ级4个(4.60%),Ⅲ级2个(2.30%)。两组差异有显著统计学意义(χ~2=20.34,P<0.001)。结论回声均匀程度、网格征及血流丰富程度对HAML与HH具有鉴别诊断意义。
Objective To compare the two-dimensional ultrasound and color Doppler flow imaging of hepatic angiomyolipoma (HAML) and compare them with hepatic hemangiomas (HH) to improve the discrimination between the two. Methods Totally 61 HAML patients (72 lesions, HAML group) were confirmed by pathology, including 13 males and 48 females. The average age was 41.67 years old, ranging from 29 to 53 years. HH patients in the same period 70 cases (87 lesions, HH group), including 26 males and 44 females; aged 32 to 56 years, mean age 46.13 years. Two-dimensional ultrasonography and color Doppler flow imaging features such as the number of lesions, the maximum diameter of the tumor, the location, the boundary, the level of the echo, the uniformity of echoes, the differences of the grids and the degree of blood flow abundance were analyzed. Results The two-dimensional ultrasound images HAML and HH showed significant differences in echo uniformity and mesh sign (P <0.05). There was no significant difference in the number of lesions, the maximum diameter of tumor, location, boundary and echo (P> 0.05). In color Doppler flow imaging, the blood flow of HAML group was 36 (50.00%) in grade 0, 12 (16.67%) in grade I, 20 (27.78%) in grade II and 4 (5.56% Group 0 69 (79.31%), Ⅰ grade 12 (13.79%), Ⅱ grade 4 (4.60%), Ⅲ grade 2 (2.30%). The difference between the two groups was statistically significant (χ ~ 2 = 20.34, P <0.001). Conclusions Echo uniformity, grid pattern and the degree of blood flow are of significance for differential diagnosis between HAML and HH.