肝实质一过性异常强化：肿瘤与炎性病变对比研究

目的探讨不同肝脏病变间动态增强CT扫描肝实质一过性异常强化(THAE)的表现特征及临床意义。方法收集肝脏或腹部病变为肿瘤类和炎性病变并伴有动态CT扫描肝实质一过性异常强化征象病例43例,所有病例病变均由病理或临床资料证实。通过分组并对肝实质一过性异常强化征的形态、分布部位、强化特点等多方面进行对比分析。结果肿瘤组THAE征均呈楔形、不规则形或节段形,分布于病灶一侧或远离病灶,边界多清楚。炎症组引起的THPE多呈大叶、大片或斑片状,与炎性病灶相临或环绕炎性病灶分布,边界欠清。肿瘤组与炎性病变组对比,动态增强扫描时动脉期肝实质一过性异常强化征在形态和发生部位方面差异性具有统计学意义。结论不同病变伴有特征的动脉期肝实质一过性异常强化征的表现,对于肝内病变的定性和鉴别诊断有参考价值。

Comparative study of the transient hepatic abnormal enhancement during dynamic contrast-enhanced spiral CT between tumor and inflammatory disease

Objective To estimate the features of transient hepatic abnormal enhancement (THAE) during dynamic contrast-enhanced spiral CT with different hepatic disease and its significance. Methods Forty-three patients with transient hepatic abnormal enhancement in the hepatic arterial phase during dynamic contrast-enhanced spiral CT, 23 with the tumor, and 20 with the inflammatory disease. Diagnosis of all cases was confirmed by pathology or clinical data. The shape, location and enhanced character of THAE imaging were studied by comparative analysis. Results The most THAE associated with the tumor showed the wedge-shape or irregular shape imaging, closing to tumors or bordering on the livers or far from tumors. Most of the THAE fringe was distinct. The THAE associated with hepatic inflammatory disease showed the imaging of leaf or large patchy shaped or segment shape, locating around the inflammatory disease. The fringe of THAE was illegibility. Changes of shape and location in transient hepatic abnormal enhancement were significantly different between tumor and inflammatory disease. Conclusion There is significant difference of transient hepatic abnormal enhancement CT images in shape and distribution between tumor and inflammation. The THAE sign has important value in diagnosis and differentiation of hepatic diseases.