弥漫型脂肪肝内局灶性病变的CT诊断  

CT Diagnosis of Focal Hepatic Lesions in Diffuse Fatty Liver

作　　者：唐建华[1] 张开华[1] 阎伟伟[1] 

机构地区：[1]复旦大学附属中山医院分部(肿瘤中心)放射科,上海市200052

出　　处：《临床放射学杂志》2008年第11期1502-1505,共4页Journal of Clinical Radiology

摘　　要：目的研究在弥漫型脂肪肝背景下肝局灶性病变的CT特征,以提高对其诊断的准确率。资料与方法回顾性分析40例弥漫型脂肪肝合并局灶性病变(35例)或残存肝岛(5例)患者的CT资料,观察脂肪肝对肝局灶性病变CT表现的影响。结果40例弥漫型脂肪肝中,26例合并多发局灶性肝病变,9例合并单发病变,5例残存肝岛。35例肝局灶性病变中,转移瘤18例,肝细胞癌(HCC)术后复发2例,血管瘤8例,多发囊肿5例,多发腺瘤及单发局灶性结节增生(FNH)各1例。CT平扫肝局灶性病变相对密度随脂肪肝程度而异,边界多不清,增强后强化方式则与无脂肪肝背景的肝内病变相似。结论弥漫型脂肪肝内局灶性病变,其CT表现与正常背景下有所差异,增强检查尤其是动态增强对病变的诊断与鉴别具有重要意义;对不典型病例,随访对比有助于正确诊断。Objective To study the CT features of focal hepatic lesions in diffuse fatty liver and to improve its diagnostic accuracy. Materials and Methods CT findings of 40 cases of diffuse fatty liver with focal hepatic lesions （ n = 35 ） or focal sparings （ n = 5 ） were analyzed retrospectively, and the changes of CT images of focal hepatic lesions in diffuse fatty liver were observed. Results In 40 cases of diffuse fatty liver, mulitple lesions were present in 26 cases, single lesion was in 9 cases,and focal sparing in the fatty liver was in 5 cases. In 35 cases of focal hepatic lesions,there were 18 cases of hepatic metastases,2 cases of hepatocellular carcinoma,8 cases of haemangioma,5 cases of mulitple hepatic cysts, 1 case of mulitple hepatic adenomas and 1 case of focal nodular hyperpiasia. The CT appearances on plain scan of focal hepatic lesions were different in fatty liver and the manners of contrast enhancement of hepatic lesions in fatty liver were similar to those without fatty liver. Conclusion The CT appearances of focal hepatic lesions in diffuse fatty liver are different to those without fatty liver. Contrast enhancement can be very helpful for diagnosis and differential diagnosis. To atypical cases, follow-up reexamination is useful for correct diagnosis.

关 键 词：脂肪肝 局灶性病变 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]