螺旋CT三期增强扫描对肝内结节性占位病变的应用价值

目的：探讨螺旋CT三期增强扫描对肝内结节性占位病变的诊断价值。方法回顾性分析2010年1月-2014年3月在我院CT检查发现的直径≤5cm的肝内结节性占位病变的平扫及三期增强表现。结果肝细胞癌10例，表现为动脉期强化明显，门脉期、延迟期呈低密度。肝转移瘤7例，表现为动脉期强化不明显，门脉期边缘环状强化，延迟期低密度。血管瘤8例，表现为动脉期病灶边缘（较小者整个病灶）高密度强化，门脉期增强区逐渐向病灶中心扩散，延迟期变成等密度。炎性假瘤3例，表现为动脉期强化不明显，门脉期、延迟期病灶边缘环形强化。结核瘤1例，门脉期、延迟期轻度环形强化。肝囊肿9例，三期均未见强化。结论大部分肝内结节性占位病变在螺旋CT三期扫描图像上有其特征性表现，能做出定性诊断。

Evaluation of three dynamic contrast-enhanced scan with spiral CT in the diagnosis of hepatic tubercular lesions

Objective To evaluate the value of the three dynamic contrast-enhanced scan with spiral CT in hepatic tu-bercular lesion. Methods Retrospectively 38 cases with hepatic tubercular lesions less than 5cm were studied , which were performed with the three dynamic contrast-enhanced scan with spiral CT in our hospital from Jun. 2010 to Mar. 2014. Results Ten cases of hepatocellular carcinoma were characterized by lower density in the venous and delay phase, and obviously enhanced in the arterial phase. 7 cases of liver metastases were characterized by less enhanced in the arterial phase, loop in the venous phase, lower density in the delay phase. 8 cases of hemangioma were charac-terized by tubercular in the arterial phase , concentric enhanced in the venous phase , equidensity in the delay phase. 3 cases of inflammatory pseudo tumors were characterized by less enhanced in the arterial phase , concentric en-hanced in the venous phase and delay phase. 1 case of tuberculoma were characterized by slightly loop especially in the venous and delay phase. Not enhanced in the all the phase for 9 cases of cysts. Conclusion The imaging of three dynamic contrast-enhanced scan with spiral CT are characteristic in mostly hepatic tubercular lesion , and could pro-vide reference to qualitative diagnosis.