探讨原发性肝癌（肝癌）患者肝移植术后腹部肝外转移的常规超声及超声造影表现。

回顾性分析2008年12月至2018年12月中山大学附属第三医院收治的50例肝癌肝移植术后腹部肝外转移患者临床资料。其中男49例，女1例；平均年龄（51±9）岁。原发病：肝细胞癌49例，胆管细胞癌1例。患者均签署知情同意书，符合医学伦理学规定。采用常规超声和（或）超声造影进行肝移植术后复查，总结肝癌肝移植术后腹部肝外转移灶的常规超声和超声造影声像学特点。

超声首次检出时间为17 d～50个月，中位时间7个月。超声首次检出时转移灶直径为0.7～11.1 cm，中位直径2.6 cm。多发性转移灶45例，伴肝内转移35例。转移部位：第一肝门区淋巴结30例，肠系膜淋巴结20例。转移灶形态规则，与周边组织分界清晰36例；病灶之间有融合12例。病灶内部表现为均匀低回声47例，不规则液化坏死区域3例，均无明显钙化。彩色多普勒超声检查病灶内部有彩色血流信号15例。16例同时进行了超声造影检查，病灶不均匀增强13例，其中周边厚环状增强7例，不规则增强5例，不规则带状增强1例。

超声检查对肝癌肝移植术后腹部肝外转移可以有效检出，转移灶大部分表现为多发、边界清晰、均匀的低回声团，仅有小部分病灶内可探及彩色血流信号。

To investigate the findings of conventional and contrast-enhanced ultrasound of extrahepatic abdominal metastasis in patients with primary liver cancer (PLC) after liver transplantation (LT).

Clinical data of 50 PLC patients with extrahepatic abdominal metastases after LT admitted to the Third Affiliated Hospital of Sun Yat-sen University from December 2008 to December 2018 were retrospectively analyzed. Among them, 49 patients were male and 1 female, aged (51±9) years on average. Primary diseases: 49 cases were diagnosed with hepatocellular carcinoma and 1 case of cholangiocarcinoma. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients were followed up after LT by receiving conventional and/or contrast-enhanced ultrasonography. The ultrasonographic manifestations of extrahepatic abdominal metastases were summarized.

The time of initial detection of metastatic lesions by ultrasound was 17 d-50 months with a median time of 7 months. The diameter of metastatic lesions was ranged from 0.7 to 11.1 cm with a median diameter of 2.6 cm when first detected by ultrasound. Multiple metastases were found in 45 cases, of whom 35 cases were complicated with intrahepatic metastases. Metastatic sites: 30 cases of lymph nodes in the porta hepatis, 20 cases of lymph nodes in the mesentery. The metastatic lesions in 36 cases were in regular shape and had clear boundary with surrounding tissues. And the metastatic lesions in 12 cases had no clear boundary. Homogeneous hypoecho was detected within the lesions in 47 cases and irregular liquefaction necrosis in 3 cases without evident signs of calcification. Color doppler flow signals were found inside the lesions in 15 cases by color Doppler ultrasound. 16 cases also received contrast-enhanced ultrasonography. Lesions with uneven enhancement were found in 13 cases, including 7 cases of peripheral thick annular enhancement, 5 cases of irregular enhancement and 1 case of irregular band enhancement.

Ultrasonography can effectively detect the extrahepatic abdominal metastases of PLC after LT. Most of the metastatic lesions are multiple, with well-defined boundary and homogeneous hypoechoic masses, whereas color blood flow signals can be detected in small portion of lesions.