肝脏灌注异常在急性胆囊炎诊断中的价值  

Diagnostic value of hepatic perfusion disorders in acute cholecystitus

作　　者：鲁观春[1] 

机构地区：[1]广东省佛山市顺德第一人民医院附属杏坛医院放射科,广东佛山528325

出　　处：《医学影像学杂志》2012年第12期2058-2059,2063,共3页Journal of Medical Imaging

摘　　要：目的探讨多层螺旋CT增强扫描肝脏灌注异常在急性胆囊炎诊断中的价值,分析肝脏灌注异常形成的因素。方法搜集26例急性胆囊炎病例在螺旋CT平扫后进行二期CT增强扫描的资料。扫描范围为全肝与胆囊;层厚为5.0～7.5mm,对比剂为碘海醇,采用团注法注入剂量为80～100ml,流速3.0～3.5ml/s。延迟时间:动脉期延迟24～28s、门静脉期延迟70～75s。结果 26例急性胆囊炎有24例(92.3%)肝脏在动脉期出现斑片状、片状及半环状异常强化,异常强化区的范围为胆囊附近肝脏组织,静脉期肝脏异常灌注消失。结论急性胆囊炎周围肝脏组织的炎性浸润、充血是形成异常灌注强化的病理基础。胆囊周围肝脏组织灌注异常是急性胆囊炎的重要CT征象,在诊断急性胆囊炎中具有重要价值。Objective To discuss the diagnostic value of multi--layer screw CT enhancement scanning in hepatic perfu- sion disorder in acute cholecystitus and to analyze the factors that resulted in the occurrence of this disorder. Methods The data of 26 patients with acute cholecystitus, who firstly received plain CT and, subsequently, underwent enhanced CTment scanning, were collected in this work. The scanning scope included the entire liver and gallbladder. The thickness of layer for scanning was 5.0~7.5 mm, the contrast agent was iohexol that was injected into body with a dosage of 80~ 100 ml and a speed of 3.0~3.5 ml/s. The delay time was that the artery time retarded 24~28 s and the portal vein time retarded 70~75 s. Results Of these 26 patients with acute cholecystitus, 24 appeared the spot laminated shape, the lami- nated shape in the artery time and half ring--like exceptionally strengthening. The abnormally strengthening scope con- ~ined to liver tissue adjacent to gallbladder. However, perfusion disorder disappeared in the vein time. Conclusion The in- flammatory infiltration and hyperemia around the liver tissues in acute cholecystitus are the pathological foundation for he- patic perfusion disorder. The hepatic perfusion disorder in liver tissues around the gallbladder is an important CT sign of a- cute cholecystitus, which possesses great value in the diagnosis of acute cholecystitus.

关 键 词：急性胆囊炎 灌注异常 体层摄影术 X线计算机 

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