320排CT在糖尿病并发细菌性肝脓肿中的诊断价值  

The diagnostic value of 320 row CT in diabetes companied with pyogenic hepatic abscess

作　　者：郭瑞 马静 方佳 杜向东 安甲佳 GUO Rui;MA Jing;FANG Jia;DU Xiangdong;AN Jiajia(Department of Radiology,the Second Affiliated Hospital of Medical School of Shihezi University,Shihezi 830002,China)

机构地区：[1]石河子大学医学院第二附属医院(兵团医院)医学影像科,新疆石河子830002

出　　处：《实用放射学杂志》2018年第9期1386-1389,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81660283）。

摘　　要：目的 探究评估320排CT动态增强扫描对糖尿病并发细菌性肝脓肿的诊断价值。方法 选取经超声引导下穿刺或外科手术确诊的细菌性肝脓肿患者110例作为观察对象，其中非糖尿病并发细菌性肝脓肿（NDPHA）A组与糖尿病并发细菌性肝脓肿（DPHA）B组各55例，采用CT平扫及动态增强的方法对肝脓肿各阶段的表现征象进行扫描成像。结果 A组病变部位发生于左叶23例，右叶21例，同时发生于肝左、右2叶11例，增强扫描动脉期出现环形强化的脓肿壁和周围的无强化的低密度水肿带形成所谓的“环征”，常多见“双环征”，周围没有水肿者CT表现为呈单环，即“环征”和脓肿内的小气泡为脓肿的特征性表现。静脉期及延迟期：脓肿壁仍有强化，脓腔和周围水肿带呈低密度。B组病变部位发生于左叶9例，右叶37例，同时发生于肝左、右2叶9例，增强扫描动脉期出现33例病灶“片状”或“楔形状”的一过性强化，门静脉期出现16例“团块状”强化，10例出现“晕征”，29例出现“蜂窝征”或“网格征”。 结论 320排CT动态增强扫描可以体现DPHA的影像学特征，是临床重要的检查手段之一。Objective To explore and estimate the diagnostic value of 320 row CT dynamic enhanced scan in diabetes companied with pyogenic hepatic abscess（DPHA）.Methods 110 cases of pyogenic hepatic abscess confirmed by ultrasound guided puncture or surgical operation were involved in this study,including 55 cases with nondiabetes companied with pyogenic hepatic abscess（NDPHA） in group A and also 55 cases with DPHA in group B. CT plain scan and dynamic enhancement were used to show the imaging signs of liver abscess at different stages. Results Group A lesions located in the left lobe in 23 cases, in the right lobe in 21 cases, and in the both lobes in 11 cases. In the arterial phase of the enhanced scan, an annular enhancement of the abscess wall and the low density edematous zone formedthe so-called ＂ring sign＂ , usually ＂double ring sign＂.CT showed a single ring when there was no edema around. Ring sign and small bubbles in the abscess was the characteristic manifestation of the abscess. In the venous phase and delay period, the abscess wall was still enhanced, and the abscess cavity and surrounding edema zone showed low density. In Group B, the lesions located in the left lobe in 9 cases,in the right lobe in 37 cases, and in both lobes in 9 cases.In the enhanced arterial phase,lamellar or wedge transient arterial phase enhancement occurred in 33 cases.In portal venous phase, ＂bolus enhancement＂ appeared in 16 cases, ＂halo sign＂ in 10 cases and ＂Honeycomb sign＂ or ＂mesh sign＂ in 29 cases,Conclusion 320 row dynamic contrast enhanced CT is able to show the characteristic of the imaging manifestation of DPHA, which is one of the most important clinical diagnostic method.

关 键 词：糖尿病 细菌性肝脓肿 计算机体层成像 

分 类 号：R587.2[医药卫生—内分泌] R814.42[医药卫生—内科学]