摘要
目的:通过分析多种原发灶来源的胰腺转移性肿瘤(pancreatic metastatic tumors,PM)的超声造影(contrastenhancedultrasound,CEUS)表现,旨在提高对PM的诊断效能。方法:回顾并分析自2015年1月—2019年9月于上海交通大学附属第一人民医院就诊的13例PM患者的临床及超声资料,患者均在手术切除或穿刺介入前行常规超声和CEUS检查。结果:经病理学检查证实11例PM,原发灶来源为肺癌3例,胃腺癌3例,肝胆管细胞癌1例,甲状腺滤泡癌1例,胆囊腺癌1例,胆总管腺癌1例,肾透明细胞癌1例;其余2例结合病史考虑为腹腔间叶源性肿瘤和肝细胞癌来源。常规超声显示,PM表现为边界清晰的低回声肿块,回声多均匀,仅4例彩色多普勒血流显像探及血流信号。CEUS显示,7例PM表现为向心性增强,6例为整体增强;在动脉期,7例呈高增强,6例呈低增强;在静脉期,仅2例呈高增强,余11例呈低增强。结论:CEUS上PM可呈特异的向心性增强方式;根据原发灶来源不同,PM呈富血供或乏血供表现。
Objective:To improve the diagnostic efficiency of contrast-enhanced ultrasound(CEUS)in pancreatic metastatic tumors(PM)through retrospective analysis of 13 PM from multiple primary origin.Methods:The clinical data of 13 patients with PM treated in Shanghai General Hospital from Jan.2015 to Sep.2019 were analyzed.All patients were examined by conventional ultrasound and CEUS before surgical resection or puncture intervention.Results:The primary lesion of PM were confirmed by pathology in 11 cases,including 3 cases of lung cancer,3 cases of gastric adenocarcinoma,1 case of hepatobiliary carcinoma,1 case of thyroid follicular carcinoma,1 case of gallbladder adenocarcinoma,1 case of common bile duct adenocarcinoma and 1 case of renal clear cell carcinoma.The primary lesions of rest 2 PM were diagnosed as peritoneal tumors and hepatocellular carcinoma by clinical history and imaging examination.Conventional ultrasound showed that most of the PM were hypoechoic masses with clear boundaries,and the echoes were homogeneous.Color Doppler flow imaging showed that only 4 cases had abundant blood flow signals.On CEUS images,7 cases showed centripetal enhancement,and 6 cases showed overall enhancement.In the arterial phase,7 cases appeared as hyper-enhancement and the other 6 showed hypo-enhancement.In the venous phase,11 cases showed hypoenhancement and only 2 cases showed hyper-enhancement.Conclusion:Centripetal enhancement was a more specific enhancement pattern of PM.PM could be represented as hypervascular or hypovascular based on different origin of primary lesion.
作者
陈文莉
李凡
杜联芳
吴蓉
李朝军
胡文洁
于洁
CHEN Wenli;LI Fan;DU Lianfang;WU Rong;LI Zhaojun;HU Wenjie;YU Jie(Department of Ultrasound,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 200080,China;Department of Radiology,The Fourth People’s Hospital of Zunyi City,Zunyi 563000,Guizhou Province,China)
出处
《肿瘤影像学》
2020年第4期385-389,共5页
Oncoradiology
关键词
胰腺
转移性肿瘤
超声造影
增强方式
血供
Pancreatic
Metastatic tumor
Contrast-enhanced ultrasound
Enhancement pattern
Blood supply
