镰状韧带旁肝左叶假病灶的螺旋CT表现

目的研究镰状韧带旁肝左叶低密度假病灶(简称镰旁肝假病灶)的螺旋CT平扫及动态增强扫描表现特征.方法 1999年1月至2001年9月926例患者因各种原因接受了肝脏或上腹部螺旋CT扫描,共检出63例(男27例,女36例;年龄15～73岁)具有镰旁肝假病灶,详细观察和记录其部位、大小、形状以及平扫与增强各期图像上的密度及其变化情况.结果 63例(6.8%)共有66个镰旁肝假病灶,均位于肝左叶内侧段(57个)或(和)左叶外侧段(9个)前缘镰状韧带旁.60例(95%)为单个镰旁肝假病灶,3例(5%)各有2个镰旁肝假病灶(分别位于左叶内侧段和左叶外侧段而呈对称性分布).据镰旁肝假病灶在平扫与双期增强图像上的密度及其变化情况将其分为A型和B型,其中A型57例60个(91%),B型6例6个(9%).结论镰旁肝假病灶并非很少见.其发生部位特殊,在螺旋CT平扫及动态增强扫描各期的密度及其变化有特征性表现.对镰旁肝假病灶应能正确识别,以免误诊.

Spiral CT features of pseudolesions in the left hepatic lobe adjacent to the falciform ligament

Objective To investigate the features of low attenuation pseudolesion in the left hepatic lobe adjacent to the falciform ligament by unenhanced and dynamic enhanced spiral CT. Methods Spiral CT scanning of the liver or upper abdomen was performed in 926 patients with various causes from January 1999 to September 2001. Sixty three patients (27 male, 36 female; age range: 15-73 years) were identified to have low attenuation pseudolesion in the left hepatic lobe adjacent to the falciform ligament. The features of pseudolesions on unenhanced and all enhanced images were carefully analyzed. Results A total of 66 low attenuation pseudolesions, 57 at the anterior border adjacent to the falciform ligament of the medial segment of left lobe of liver, and 9 at that of the lateral segment of left lobe of liver, were found in 63 patients (6.8%). Single pseudolesion was found in 60 patients (95%), but 3 patients (5%) had 2 pseudolesions located symmetrically in the medial segment of the left lobe and the lateral segment of the left lobe, respectively. The pseudolesions were divided into type A (60 pseudolesions, 91%) and type B (6 pseudolesions, 9%) according to their attenuations and the changes of attenuations on the unenhanced and dynamic enhanced spiral CT images. Conclusion Low attenuation pseudolesions are not unusual in the left hepatic lobe around the falciform ligament by spiral CT. They have characteristics in locations, attenuations, and changes of attenuations on unenhanced and dynamic enhanced spiral CT images. Radiologists should recognize these pseudolesions correctly for avoiding misdiagnosis.