吉林大学学报（医学版）2019，Vol.45Issue(1)：163-169,7.DOI:10.13481/j.1671-587x.20190131
动脉期强化不明显肝脏占位性病变的CT表现及其在鉴别诊断中的意义
CT manifestations of hepatic lesions without obvious enhancement in arterial phase and their significancs in differential diagnosis
摘要
Abstract
Objective:To study the CT findings of hepatic lesions without obvious enhancement in arterial phase, and to analyze the characteristics of the hepatic lesions.Methods:The clinical materials of 118cases of hepatic lesions without obvious enhancement in arterial phase scanned by enhanced CT were collected.The basic CT signs, characteristic CT signs and enhancement patterns were analyzed.Results:Among 118cases, there were 40hepatic metastases, 29liver abscesses, 21intrahepatic cholangiocelloma, 17hepatocellular carcinoma, 6inflammatory pseudotumor of liver and 5hepatic lymphoma;54cases showed single lesion and 64cases showed multiple lesions;24cases were sharp and 94cases were indistinct;41cases located in right hepatic lobe, 26cases located in left hepatic lobe, 50cases located in left and right hepatic lobe, and 1case located in hepatic caudate lobe.The diameters of lesions were 0.2-13.4cm.40cases of hepatic metastases showed mild marginal enhancement, while the incidence rate of bull eye sign was 12.50％ (5/40) ;29cases of liver abscess showed ring or honeycomb-like enhancement, while the incidence rates of double ring sign and gas bubbles were 13.79％ (4/29) and 13.79％ (4/29) .Seventeen cases of intrahepatic cholangiocelloma showed slow progressive enhancement, while the incidence rates of intrahepatic bile duct dilatation, hepatic capsular depression and calcification were 57.14％ (12/21) , 23.81％ (5/21) and 9.52％ (2/21) .Seventeen cases of hepatocellular carcinoma showed various enhancement patterns, while the incidence rates of liver contour change, hepatic artery enlargement and vessel invasion were 41.18％ (7/17) , 41.18％ (7/17) and 35.29％ (6/17) .Four cases of inflammatory pseudotumor of liver showed septal and nodular enhancement;5cases of hepatic lymphoma showed internal minimal homogeneous enhancement, while the incidence rate of'vascular floating'sign was 40.00％ (2/5) .Conclusion:Spiral CT examination of the hepatic lesions without obvious enhancement in arterial phase should be combined with CT signs and enhancement patterns for synthetic judgment, which is helpful to provide an important basis for the qualitative and differential diagnosis of liver lesions.关键词
肝脏/占位性病变/电子计算机断层扫描/动态增强/鉴别诊断Key words
liver/lesions/computed tomography/dynamtic contrast enhancement/differential diagnosis分类
医药卫生引用本文复制引用
冯晴,文明..动脉期强化不明显肝脏占位性病变的CT表现及其在鉴别诊断中的意义[J].吉林大学学报（医学版）,2019,45(1):163-169,7.基金项目
国家卫计委临床重点专科建设项目资助课题(国卫办[2013]544号) （国卫办[2013]544号）
