肝脓肿的多层螺旋CT表现及临床价值(附20例分析)

目的　探讨肝脓肿在多层螺旋CT(MSCT)双期或 /和三期 (动脉期、门静脉期、延迟期 )增强扫描的表现及临床价值 ,特别是在动脉期的表现。方法　观察 2 0例经手术或穿刺证实的肝脓肿在多层螺旋CT双期或 /和三期扫描在动脉期与门静脉期的CT表现 ,特别是在动脉期的表现。动脉期是在注射造影剂后 2 5s开始扫描 ,门静脉期是 65s开始扫描 ,延迟是 5min开始扫描 ,每期全肝扫描所用时间为 8～ 10s。结果　 ( 1)动脉期表现 :肝内低密度或略低密度灶周围肝组织强化明显 ,而病灶本身或边缘无明显强化或轻度强化。 ( 2 )门静脉期表现 :a、环靶征 ;b、环状征 ;C、花瓣征 ;d、分房状征。 ( 3)延迟期表现 :病灶缩小或不变 ,水肿带消失或模糊。结论　多层螺旋CT双期或三期扫描充分反映了肝脓肿的病理变化 ,对早期诊断肝脓肿及鉴别诊断有重要价值

MSCT Findings and Clinic Value of Hepatic Abscesses (An Analysis of 20 Cases)

Objective To study MSCT findings and clinic value of hepatic abscesses on enhanced double-phase and(or)three-phase(arterial and protal venous phase and delayed phase),especially during arterial phase. Methods The MSCT imaging features of 20 cases with hepatic abscesses proved by operation or biopsy were evaluated on enhanced double-phase and(or) three-phase scan during arterial and portal venous phase and delayed phase ,especially during arterial phase.Results (1)The imaging features of aeterial phase were that the hepatic tissues around the lesions showed strong enhancement,but the lesions showed slight enhancement or not or peripheral enhancement. (2)The imaging features of protal venous phase were:a.circular target sign; b.circular sign; c.flower valve sign; d.multiloculated sign. (3)The imaging features of delayed phase were that the masses changed smaller or not and the belt disappeared or got vague. Conclusion The double-phase or three phase MSCT scan fully reflects the pathologic changes of hepatic abcesses and is very important to early diagnosis and differential diagnosis.