肝脏一过性灌注异常在螺旋CT诊断急性胆囊炎中的价值

目的 探讨急性胆囊炎患者增强扫描动脉期肝脏一过性灌注异常形成的病理生理及其在急性胆囊炎诊断中的价值.方法 收集临床及影像资料完整并经手术或临床证实的急性胆囊炎共52例,所有病例均经上腹部CT平扫＋三期扫描,分析急性胆囊炎胆囊床邻近肝脏组织一过性灌注异常的CT表现及其病理生理.结果 52例急性胆囊炎病例中,46例出现胆囊床邻近肝组织出现楔形、三角形异常强化,门静或肝静脉期异常强化程度明显下降,平衡期病变所在区域与正常肝组织密度均匀一致,其内血管纹理分布规则,无明显占位效应.结论 急性胆囊炎胆囊床邻近肝组织炎性浸润,使受累区域肝组织内门静变窄,血流量降低,肝动脉血流量增加,从而出现肝动脉一过性灌注异常.胆囊床周围出现肝组织一过性灌注异常是急性胆囊炎的重要影像学表现,对诊断急性胆囊具有重要价值.

Value of transient abnormal perfusion in the diagnosis of acute cholecystitis by spiral CT

Objective To study the pathophysiology of acute cholecystitis patients in arterial phase enhanced scanning of liver transient abnormal perfusion and its value in the diagnosis of acute cholecystitis. Methods The clin- ical and imaging data of 52 patients with acute cholecystitis confirmed by operation were collected, and all the patients were performed upper abdominal CT scan plus three phase scanning. Pathologic and physiologic perfusion abnormali- ties after CT manifestations of gallbladder bed adjacent liver tissue in acute cholecystitis were analyzed. Results In 52 the cases, 46 cases of gallbladder bed adjacent liver tissue appeared wedge, triangle abnormal enhancement, de- creased enhancement in portal vein or hepatic vein, with the stage lesion area uniform from normal liver tissue in bal- ance and the blood vessel in rule of distribution. No obvious space occupying effect was found. Conclusion In acute cholecystitis, the gallbladder bed adjacent liver tissues show inflammatory infiltration, narrowed regional involvement of portal vein in liver tissue, decreased blood flow, increased hepatic artery blood flow, thus appeared a transient abnor- mal perfusion of hepatic artery. Perfusion abnormality of liver tissue around the gallbladder bed is an important imag- ing of acute cholecystitis, and it has important value in the diagnosis of acute cholecystitis.