宝石能谱CT对肝脓肿诊断的价值  

Dual energy spectral CT diagnostic value of liver abscess

作　　者：关长旭[1] 宋瑞娟[1] 张旭升 

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院CT室,017000 [2]内蒙古自治区鄂尔多斯市鄂托克前旗人民医院CT室

出　　处：《实用医学影像杂志》2015年第5期423-425,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨利用能谱CT对肝脓肿的诊断价值。方法对我院2014年2月至12月间怀疑肝脓肿的10例患者,行能谱CT三期扫描,可获得平扫图像、动脉期、门静脉期及延时扫描图像、能谱曲线图像,分析肝内病变的位置、数目、影像学表现及能谱曲线形态。结果 10例患者中病灶位于肝右叶7例,病灶位于肝左叶2例,多发病灶1例;其中典型肝脓肿2例,CT表现为"环征"、积气等典型征象;不典型肝脓肿8例,CT平扫病灶呈均匀或不均匀低密度区,形态呈类圆形、边缘模糊或较清楚,增强扫描动脉期病灶呈轻度强化,门静脉期病灶呈小环状、蜂窝状、花瓣状、网格状、簇状表现,其内见小片状不强化的低密度区,平衡期病灶强化减弱;能谱曲线显示病灶内强化部分曲线斜率低于正常肝实质,不强化部分曲线近乎直线。结论能谱CT肝脏三期扫描能够准确诊断肝脓肿,利用能谱曲线更有利于对不典型肝脓肿的诊断。Objective To explore the use of the diagnostic value of CT liver abscess spectroscopy. Methods Ten cases suspected liver abscess patients in our hospital between February-December 2014 underwent three CT scan line spectra to obtain unenhanced images, arterial, venous phase and delayed scan image and the image of spectrum curve, then analyze liver lesion location, number, imaging and spectroscopy curve shape. Results Of 10 cases ,there were 7 cases with lesions locating in the right lobe, 2 cases in the left hepatic lobe, and one case with multiple le- sions. There were 2 cases belonged to typical liver abscess with CT showing＂ring＂ sign, the product gas and other typical signs while 8 cases were atypical liver abscesses with CT scan lesion showing homogeneous or inhomogeneous density areas with round shape, edge blur or more clearly, and by enhanced scanning lesions were slightly enhanced in arterial phase, while lesions had small ring, honeycomb, petal shaped, grid, cluster-like performance in portal ve- nous phase, in which small pieces without strentben could been seen in the low-density region. The strengthen of the lesions in balance phase was reduced, and spectrum curve showed that the lesion portion of the curve slope was less than the normal liver parenchyma, and the curve without strengthen was like straight line. Conclusion Dual energy spectral CT scan can accurately diagnose liver abscess, the curve is more conducive to the use of spectrum for the di- agnosis of atypical hepatic abscess.

关 键 词：肝脓肿 诊断 计算机辅助 体层摄影术 螺旋计算机 

分 类 号：R575.4[医药卫生—消化系统]