多层螺旋CT诊断富血供肝转移瘤的价值  

Value of multi-slice spiral CT in diagnosis of liver metastases with rich blood supply

作　　者：高凯波 吕丹 吴锦 段潇 蒋辉辉 孙倩 邓士杰 Gao Kaibo;Lyu Dan;Wu Jin;Duan Xiao;Jiang Huihui;Sun Qian;Deng Shijie(Department of Radiological Diagnosis,the 921st Hospital of the Joint Logistics Support Force of Chinese People′s Liberation Army(the Second Affiliated Hospital of Hunan Normal University),Changsha 410003,China)

机构地区：[1]中国人民解放军联勤保障部队第九二一医院(湖南师范大学第二附属医院)放射诊断科,长沙410003

出　　处：《中国医师杂志》2025年第1期67-70,共4页Journal of Chinese Physician

基　　金：湖南省教育厅科学研究项目(20C1115)。

摘　　要：目的探讨多层螺旋CT(MSCT)诊断富血供肝转移瘤的价值。方法回顾性分析中国人民解放军联勤保障部队第九二一医院2018年9月—2023年9月收治的19例富血供肝转移瘤患者的临床资料及影像资料,分析病变的数目、部位、形态、大小及CT平扫、动态增强扫描的影像。结果19例患者中多发18例,单发1例。共发现108个病灶,肝右叶多见,有62个(57.4%),靠肝外周部多见,有87个(80.6%)。形态以圆形或类圆形多见,有99个,呈不规则形或分叶形9个。病灶长径0.6~6.8 cm。CT平扫显示99个病灶呈稍低密度,其余9个病灶相对背景肝呈等密度。动态增强扫描中,动脉期108个病灶均强化呈高密度,97个病灶呈环形强化,11个病灶呈结节样强化,其中77个病灶中度至明显强化密度达峰值;门静脉期108个病灶中有31个病灶中度至明显强化密度达峰值,49个病灶廓清呈稍低密度,28个病灶持续强化呈高密度;延迟期108个病灶均廓清呈稍低密度。结论富血供肝转移瘤的主要特征为:CT平扫为低密度,增强扫描动脉期呈环形或结节样强化,强化密度峰值可在动脉期也可在门静脉期。结合临床资料,CT可做出正确的诊断。Objective To evaluate the value of multi-slice spiral CT(MSCT)in the diagnosis of liver metastases with rich blood supply.MethodsThe clinical data and imaging data of 19 patients with liver metastases with rich blood supply admitted to the 921st Hospital of the Joint Logistics Support Force of Chinese People′s Liberation Army from September 2018 to September 2023 were retrospectively analyzed,and the number,location,shape,size of the lesions and the images of CT plain scan and dynamic enhanced scan were analyzed.ResultsAmong the 19 patients,there were 18 multiple cases and 1 single case.A total of 108 lesions were found.There were 62 cases(57.4%)in the right lobe of liver and 87 cases(80.6%)in the peripheral part of liver.The form of circular or quasi-circular,there were 99,irregular shape or lobed 9.The focal diameter was 0.6-6.8 cm.CT plain scan showed that 99 lesions showed slightly low density,and the other 9 lesions showed equal density relative to the background liver.In the dynamic enhanced scan,108 lesions in arterial stage showed high-density enhancement,97 lesions showed circular enhancement,and 11 lesions showed nodular enhancement.Among them,77 lesions had moderate to obvious intensification density.Of the 108 lesions in the portal vein stage,31 lesions showed moderate to obvious enhancement density,49 lesions showed slightly low clearance density,and 28 lesions showed continuous enhancement density.In the delayed stage,all 108 lesions showed slightly low density.ConclusionsThe main features of liver metastases with rich blood supply are:low density on plain CT scan,annular or nodular enhancement in the arterial phase of enhanced CT scan,and the peak of enhanced density can be in the arterial phase or the portal vein phase.Combined with clinical data,CT can make a correct diagnosis.

关 键 词：多层螺旋计算机体层摄影术 肝转移瘤 血液供给 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]