胰腺转移癌超声造影表现探讨

Abstract

目的：探讨胰腺转移癌的超声造影表现特点。方法回顾性分析11例经病理或C T、M RI等增强影像学检查及临床综合诊断的胰腺转移癌病例，观察病变常规超声表现，超声造影增强与消退速度、强化程度及强化特点。结果11例胰腺转移癌原发于肺癌6例，乳腺癌1例，肾透明细胞癌1例，胃癌1例，直肠癌1例，子宫平滑肌肉瘤1例。病灶大小20．～50．cm ，常规超声多表现为低回声病灶（8／11），8例为单发，3例为多发；常规超声3例诊断倾向或不除外胰腺转移癌，1例倾向恶性，余7例性质待定。超声造影增强早期2例（182．％）呈高增强，6例（545．％）呈等增强，3例（273．％）呈低增强；增强晚期病灶多早于胰腺廓清而呈低增强（9／11）。胰腺转移癌多表现为整体均匀团状强化（7／11）。超声造影6例诊断胰腺转移癌，3例诊断为恶性，1例诊断神经内分泌肿瘤，1例性质待定。结论胰腺转移癌的超声造影表现有别于胰腺原发癌，重视原发癌的病史、超声造影增强早期表现特点等，有助于胰腺转移癌的诊断。

Objective To explore the manifestation of pancreatic metastases (PM)using contrast‐enhanced ultrasound (CEUS). Methods Eleven patients with PM confirmed by pathology or CT/MRI combined with clinical data were analyzed retrospectively. The manifestation on conventional ultrasound and the enhancement appearance on CEUS were analyzed. Results The primary malignant tumors included lung cancer(n=6), breast cancer(n=1), renal clear cell carcinoma(n=1), gastric cancer(n=1), rectal cancer(n=1)and leiomyosarcoma of uterus(n=1). Eight patients had one lesion and three were multiple. The maximum lesion diameter was 2. 0-5. 0cm. Eight of the 11 patients showed hypoechoic on conventional US. Three patients were diagnosed as probably PM, one probably malignant and 7 undetermined by US. In the early stage of CEUS, two patients showed hyper‐enhancement, six showed iso‐enhancement and 3 showed hypo‐enhancement I.n the late stage of CEUS, nine patients (9/11) showed hypo‐enhancement. Seven patients showed homogeneous enhancement S.ix patients were diagnosed as PM, three malignant, one neuroendocrine tumor and one undetermined by CEUS. Conclusions PM showed certain characteristics on CEUS. The hyper‐or iso‐enhancement at the early stage of CEUS and history of primary cancer is helpful for diagnosis of PM.