肝脏灌注异常的多层螺旋CT表现及临床价值

目的探讨肝脏灌注异常的多层螺旋CT(MSCT)三期增强扫描表现、原因及形成机制。方法回顾性分析85例肝脏灌注异常的MSCT检查资料,根据MSCT表现对其病因及形成机制进行探讨。结果 85例HPD中,肿瘤相关性病变48例,非肿瘤病变37例。表现分为四型:①肝叶、段型;②楔型;③不规则型;④弥漫型。其形成原因大致分为:①肝内动脉、门脉分流;②门静脉阻塞;③肝静脉阻塞;④炎性充血;⑤肿瘤盗血;⑥解剖变异、迷走血管供血;⑦无明确原因。结论 MSCT三期增强扫描是目前评价各类肝脏灌注异常的最佳方法,有助于对其所反映的病理生理状况作出准确推断,避免肝脏病变的假阳性或假阴性诊断及过高估计病变的大小,有助于判断部分疾病的病情和预后。

MSCT features and clinical value of Hepatic Perfusion Disorders

Objective To discuss the features etiology and its forming mechanism of hepatic perfusion disorders in contrast-enhanced multi-slice spiral CT(MSCT).Methods According to the retrospectively analyses the information of 85 cases of hepatic perfusion disorders,discuss the MSCT features etiology and its forming mechanism.Results 85 cases of the HPD,48 cases of tumor lesions,37 cases of Non-cancerous lesions HPD was divided into four types: ①live segmental type;②wedge-shaped type;③irregular type;④diffuse type.The etiologies of hepatic perfusion disorders were classified as ①arterio-portal shunts;②portal venous obstruction;③hepatic venous obstruction;④inflammatory hyperemic change;⑤steal phenomenon by tumors;⑥anatom-variation and aberrant blood supply;⑦uncertain causes.Conclusion currently,contrast-enhanced multi-slice spiral CT(MSCT) is the best way in evaluating various types of hepatic perfusion disorders it can reflect the pathophysiological conditions accurately,to avoid false positive or false negative diagnosis of liver lesions and overestimate the size of the lesion,can help to determine the part of the condition and prognosis of the disease.