肝臟結節在追蹤期間超音波回音型式發生改變：病例報告

Change of Echopattern in a Hepatic Nodule during Follow-up Studies: a Case Report

林裕祥(Yu-Hsiang Lin) ； 賴巧心(Chaio-Hsin Laih) ； 梁妍羚(Yan-Ling Liang) ； 周宜宏(Yi-Hong Chou)

《北市醫放雜誌》 3卷1期 (2013/12) Pp. 35-40

https://doi.org/10.6663/TPART.2013.3.1.35

摘要

低惡性危險的肝臟結節，適合利用超音波做追蹤檢查。當結節太小或者不典型時，使用超音波儀器做追蹤檢查，對病人而言非常重要。只要結節的回音型式與大小發生明顯變化，就要高度懷疑是否為惡性腫瘤。本文提出一個案例起初診斷是肝臟血管瘤，開刀後病理證實是膽管癌，前兩年結節的大小並未改變，但回音型式發生變化，第四年腫瘤才變大，因此認為回音型式的改變應視為診斷惡性腫瘤的一個重要參考依據。

關鍵字

肝臟結節 ； 超音波 ； 血管瘤 ； 膽管癌

並列摘要

It's appropriate to do follow-up sonography for liver nodules with relatively low risk of malignancy. When the nodules are too small or atypical for malignancy on imaging studies, it's mandatory and important to keep track of sonograms. Once the echopattern and size change significantly, the nodules should be suspected to be malignant. We herein report a case diagnosed as a hemangioma at the initial imaging studies and being followed up for 4 years. On the first 2-3 years sonograms, the lesion showed no remarkable change in size but echopattern changed. On the 4^(th)-year sonogram, the lesion grew from 1.7 cm to 2.8 cm. The patient then underwent surgery. The lesion was pathologically proved to be a cholangiocarcinoma after surgery. The change of echopattern even without significant size enlargement should be considered an important clue to diagnose a malignant tumor.

並列關鍵字

liver nodule ； sonogram ； hemangioma ； cholangiocarcinoma