综合影像学检查对肝肾间隙巨大占位病灶的定位诊断

目的：综合几种影像诊断方法的优势，总结新的影像学特点，提高肝肾间隙巨大占位病灶的诊断水平。方法：分析手术病理证实的35例肝肾间隙巨大肿块的影像学资料，比较CT、MR、B超、多普勒超声及综合影像组对各重要结构和定位征象的显示率，并对照各影像方法定位诊断正确率。观测肿块中心点与右腹中线（C线）的位置,及肿块与肝下缘的夹角。结果：综合影像组对重要结构和征象的显示率及定位诊断的正确率均明显高与单个影像组。各种影像手段各有独特优势。肝源性病灶中心点位置多位于右腹中线外侧，肾上腺源性占位中心多位于该线内侧，肝源性病灶与肝下缘的夹角多在内侧，肾上腺源性夹角多在外侧或双侧。结论：几种影像方法相结合能对大多数肝肾间隙巨大占位灶进行正确的定位诊断，病灶中心与右侧腹中线的位置关系及病灶与肝下缘的夹角可作为定位参考征象。

Comprehensive imaging in localizattion of massive space occupying lesions in hepato-renal space

To sum up new imaging features of massive space occupying lesion in hepato renal space by means of comprehensive imaging modalities to improve the diagnosis.Methods:Imaging data of 35 cases of massive space occupying lesion in hepato renal space confirmed by surgery and pathology were retrospectively analyzed.The detectability of important structures and localizing accuracy of US,CDFI,CT,MRI and comprehensive imaging were compared.It was observed for the position between the center of the mass and the right ventral median line(line C) and the angle between the mass and the inferior margin of the liver.Results:The detectability of the important structures and their features, the localizing accuracy of the mass were higher by comprehensive imaging modalities than by single imaging method. The center of the liver mass was often located lateral from right ventral median line(line C),but the center of the adrenal mass medial from line C.Conclusion:Comprehensive imaging modalities can locate correctly most massive space occuping lesions in hepato renal space.Moveover,the relation between the center of the lesion and the ventral median line, and the angle between the inferior margin of the liver and the mass can be for reference of localization.