螺旋CT在肝脓肿诊断中的应用

目的：评价螺旋CT、双期扫描对肝脓肿的诊断价值。方法：回顾性分析经临床或病理证实的28例肝脓肿的螺旋CT表现，所有病例均行平扫及螺旋CT双期增强扫描，其中5例经薄层重建后在工作站行表面遮盖重建(SSD)，并经切割处理，显示其冠、矢状位图像。结果：28例中，平扫表现为类圆形边缘不清楚的低密度灶17例，多房或簇状9例，不规则形1例，脓腔内积气1例。增强扫描动脉期28例均表现为病灶边缘极轻或轻度环状强化，其中有15例(53．5％)出现灶周楔形或片状一过性强化；门脉期显示簇状征9例，边缘强化10例，环靶征8例；另1例平扫为不规则形，增强扫描动脉期灶周出现明显楔形一过性强化，门脉期病灶内呈不规则强化，为较特殊表现。5例三维图像直观地显示了脓肿的立体形态和位置。结论：螺旋CT双期扫描对肝脓肿诊断有重要应用价值。动脉期的灶周楔形或片状一过性强化是肝脓肿又一重要CT表现，对诊断有指导意义。

Sprial CT scan:application in the diagnosis of hepatic abscess

Objective:To study spiral CT findings of hepatic abscess,and evaluate dual phase enhanced spiral CT scan in diagnosis of hepatic abscess.Methods:Spiral CT findings in 28 cases of clinically or pathologically proved hepatic abscesses were retrospectively analyzed.All cases underwent plain CT scans and dual phase enhanced spiral CT scans.5 of them were reconstructed by means of surface shaded display (SSD) and cut in coronal or sagittal direction.Results:Of the 28 cases,plain CT findings revealed low density lesion with spherical shape and ill defined margin (n=17),abscesses cluster sign (n=9),and irregular shape appearance (n=1).Some gas was seen in 1 case of abscess,and it was diagnostic significant.Of 28 cases of hepatic abscess,15 showed periabscess wedge shaped or patchy enhanced area in arterial phase (53.5%).Enhancement of the rim of the lesion (n=10),cluster sign (n=9),and double target sign (n=8) were shown in portal phase.3D imaging of 5 cases demonstrated directly the location and shape of abscesses in a stereoscopic manner.Conclusion:Dual phasic spiral CT is of great value in diagnosis of hepatic abscess. Periabscess wedge shaped or patchy enhancement in arterial phase is another valuable CT sign.