原发性肝癌自发破裂的CT评价

目的：探讨并提高对肝癌自发破裂伴腹腔内出血（血腹）的CT诊断,方法：回顾分析8例经手术证实的肝癌自发破裂临床的影像资料。分析各种病理情况的影像特征及其与肝癌破裂的关系。包括肝硬化表现,腹水,肿瘤在肝内位置,肿瘤凸出肝外程度和中心坏死情况,结果：8例患者CT扫描发现12个癌灶,其中1例CT仅见血腹而未见肝癌病灶,手术探察发现肝边缘小肝癌破裂,继发肝包膜下和腹腔积血,CT诊断肝边小肝癌的精确性达85％,结论：CT诊断肝癌自发破裂有很高的精确度,对临床怀疑肝癌自发破裂造成血腹者,CT检查十分必要。

CT evaluation of spontaneous rupture of hepatocellular carcinoma

Objective:To assess the value of CT in detection of spontaneous rupture of hepatocellular carcinoma(HCC) with resultant intraperitoneal hemorrhage.Methods:Clinical manifestation and CT findings of spontaneous rupture of HCC in 8 cases proved surgically and pathologically were reviewed. CT characters of variable pathological changes of ruptured HCC and the relationship between CT characteristics and rupture of HCC were also analyzed. An analysis was involved in the status of liver cirrhosis, ascites, intrahepatic location of the tumor, extent of extrahepatic protrusion and central necrosis of the tumor.Results:CT demonstrated 12 foci of HCC in 8 cases. 1 case showed only intraperitoneal hemorrhage and no focus of HCC. Laparotomy, however,found the rupture of small HCC on the margin of liver, with resulting subcapsular hemorrhage and hemoperitoneum. The accurate rate of CT diagnosis of small HCC on the margin of liver was up to 85%.Conclusion:The accuracy of CT diagnosis of spontaneous rupture of HCC is very high. Moreover, CT is a necessary imaging modality in the diagnosis of ruptured HCC suspected by clinical findings.