螺旋CT强化方式在肝脏局灶性病变定性诊断中的价值  

Diagnostic Value of Contrast--Enhanced CT Patterns in Focal Hepatic Lesion

作　　者：黄伟鹏[1] 陈洁容[1] 许建生[1] 陈卫鹏[1] 姚沛旭[1] 陈丽君[1] 

机构地区：[1]广东省揭阳市人民医院CT室,广东揭阳522000

出　　处：《实用放射学杂志》2010年第1期50-52,66,共4页Journal of Practical Radiology

摘　　要：目的探讨螺旋CT强化方式对肝脏局灶性病变的定性诊断价值。方法回顾性分析行肝脏螺旋CT多期增强扫描且发现局灶性病变的44例患者（54个病灶）的诊断结果，重点分析各类病灶的强化方式。结果（1）78％（14／18）的肝细胞癌表现为“快进快出”的强化方式，83％存在肝硬化背景，22％门脉可见癌栓；（2）9个肝血管瘤表现为“快进慢出”，边缘明显强化逐渐向中心充填；（3）4例胆管细胞型肝癌表现为“慢进慢出”，部分瘤灶内包埋胆管，周围可见扩张的肝内胆管；（4）14个肝转移瘤和5例肝脓肿表现为环形强化，肝转移瘤为周边程度不一的环形强化，肝脓肿则为单环或多环强化；（5）3例肝局灶性结节增生和1例肝细胞腺瘤表现为“快进慢出”，2例局灶性结节增生存在中央瘢痕并延迟强化。结论螺旋CT强化方式能充分显示肝脏局灶性病变的血供特点，对定性诊断有较高的临床价值。Objective To study the diagnostic value of contrast--enhanced CT patterns in focal hepatic lesions. Methods Contrast --enhanced CT patterns in 44 patients with focal hepatic lesions （54 loci） were retrospectively analysed. Results （1）78% of the hepatocellular carcinoma presented ＂rapid--filling and rapid--washout＂ feature. （2）All hepatic hemangioma presented ＂rapid--filling and slow-- washout＂, progressive opacification from ihe periphery to center. （ 3 ） All cholangiocarcinoma presented ＂slow-- filling and slow--washout＂ . （4）Metastatic hepatocarcinoma in 14 cases and hepatic abscesses in 5 cases were presented a enhanced ring around the lesion, metastatic hepatocarcinomas showed single ring, however, hepatic abscesses showed multi-- ring. （ 5 ） Focal nodular hy- perplasia in 3 cases and hepatic adenomas in 1 case presented ＂rapid--filling and slow--washout＂. Conclusion The contrast--en- hanced patterns at spiral CT can fully reflect the blood supply of focal hepatic lesions, it has significant value in diagnosing focal hepatic lesions.

关 键 词：肝脏 肝脏局灶性病变 体层摄影术 X线计算机 多期增强扫描 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]