多层螺旋CT动态增强扫描对不典型肝脓肿的诊断价值

摘要

目的 探讨多层螺旋CT动态增强扫描对不典型肝脓肿的诊断价值.方法 回顾性分析经临床或病理检查证实的48例不典型肝脓肿平扫及动态增强扫描各期CT表现特征.结果 48例患者中肝脓肿位于肝左叶17例,肝右叶25例,同时累及肝左、右叶6例.平扫全部病灶呈均匀低密度或不均匀等低混杂密度.增强扫描动脉期26例病灶所在肝段或灶周出现楔形或片状一过性强化;门静脉期呈团块状强化9例,出现"晕征"10例,出现"网格征"或"蜂窝征"21例;延迟期29例病灶范围较平扫时缩小,7例房间隔或蜂房壁保持持续强化.结论 多层螺旋CT动态增强扫描诊断不典型肝脓肿具有特征性,对提高不典型肝脓肿的诊断率及鉴别诊断具有重要价值.%Objective To study the diagnostic value of dynamic enhanced multislice spiral CT in atypical hepatic abscess.Methods The plain CT and dynamic enhanced CT findings of atypical hepatic abscess were retrospectively analyzed in 48 cases confirmed by pathological or clinical examinations.Results Among 48 cases,17 cases were in the left lobe,25 cases in the right lobe,6cases in both left and right lobes.In plain CT all lesions showed homogeneous density or uneven lower hybrid density.In enhanced arterial phase,26 cases appeared a wedge or slice of transient hepatic parenchyma enhancement.In portal vein phase,9 cases showed bolus enhancement,and " halo sign" of 10 cases, "Grid sign" or "honeycomb sign" of 21 cases.In delay phase,the lesion area of 29cases became smaller compared with plain CT; 7 cases maintained enhancement of the atrial septum or beehive wall.Conclusion The dynamic enhanced multislice spiral CT scan is specific in the diagnosis of atypical hepatic abscess and plays an important role in differential diagnosis.