肝脏 ›› 2022, Vol. 27 ›› Issue (12): 1284-1287.

• 肝癌 • 上一篇    下一篇

原发性肝脏肉瘤3例超声造影特征及病理分析并文献复习

臧加伟, 李丽, 陈晓, 谭碧星   

  1. 050000 石家庄 河北省人民医院超声科
  • 收稿日期:2021-12-31 发布日期:2023-01-30
  • 通讯作者: 李丽,Email:shrmgnk@126.com

Contrast-enhanced ultrasound features and pathological analysis of 3 cases with primary hepatic sarcoma

ZANG Jia-wei, LI Li, CHEN Xiao, TAN Bi-xing   

  1. Department of Ultrasound, Hebei General Hospital, Shijiazhuang 050051, China
  • Received:2021-12-31 Published:2023-01-30
  • Contact: LI Li,Email:shrmgnk@126.com

摘要: 目的 探讨原发性肝脏肉瘤(PLS)的二维超声及超声造影表现,并与病理对照分析。方法 回顾性分析河北省人民医院经病理证实的3例PLS患者的临床体征、超声表现及病理资料;复习相关文献并总结其超声造影(CEUS)及病理学诊断经验。结果 3例PLS二维超声表现为类圆形或不规则形混合回声团,呈膨胀性生长,界限清楚,中心可伴囊性变、坏死或出血。3例PLS病灶的CEUS动脉期均表现为边界清晰,有包膜,其中2例呈不均匀稍高或高增强,内部呈“火焰”征,1例周边呈高增强;中心伴大部囊变坏死或出血,呈无增强。病灶门脉期开始缓慢廓清,呈低增强,整体廓清较肝转移瘤(LM)速度慢、程度低,始终未呈“黑洞”征。结论 原发性肝脏肉瘤多为单发、边界清楚的实性肿块,临床症状缺乏特异性。但其CEUS具有一定的特征性,可为临床诊断及术前评估提供重要依据,而确诊仍需依靠病理学。

关键词: 肝脏肉瘤, 超声造影, 病理, 诊断

Abstract: Objective To investigate contrast-enhanced ultrasound (CEUS) characteristics of primary liver sarcoma (PLS) and compare the diagnostic value between CEUS and pathology.Methods The clinical data of 3 cases with PLS diagnosed by pathology were retrospectively analyzed. The relevant literature was reviewed to summarize the diagnosis experience of CEUS and pathology.Results The characteristics of two-dimensional ultrasonography were round-like or irregular-shaped mixed echogenic masses, expansion growth with clear boundary, accompanied by cystic degeneration, necrosis or bleeding in the center. CEUS arterial phase of 3 cases showed clear boundary and envelope, among which 2 cases showed uneven slightly high or high enhancement, which internal showed the “flame” sign, and the peripheral of 1 case showed high enhancement. CEUS showed the feature of center was massive cystic necrosis or hemorrhage, with no enhancement. The lesion began to be cleared slowly in the portal phase with low enhancement, and the overall clearance rate was slower than that of liver metastatic tumor (LM), and the “black hole” sign was not observed.Conclusion PLS is mostly single solid masses with clear boundaries and its clinical symptoms are not specific. However, the CEUS features of PLS are certain, which could provide an important basis for clinical diagnosis and preoperative evaluation.However, the definitive diagnosis still depend on pathology.

Key words: Hepatic sarcoma, Contrast-enhanced ultrasound, Pathology, Diagnosis