等密度肝癌的CT诊断探讨

CT Study of the Isodense Hepatocarcinoma

目的：探讨等密度肝癌的检查步骤及CT诊断价值。方法：对CT平扫检查无明显异常，再行CT增强扫描的13例等密度肝癌病例进行分析。结果：①13例中肝硬化9例，脂肝2例，乙肝2例。平扫肝均未见肿块密度灶，2例显示肝局部轮廓轻度外隆，2例肝内见直径2～3cm的环状略低密度影，环内密度与肝其它部位密度无差异。②13例增强肝内均可见单发和多发强化密度不一的低密度和略低密度结节肿块灶，多发10例，癌灶直径0．5～4cm不等，单发2例癌灶直径2～3cm。结论：肝硬化，脂肪肝合并浸润性弥漫肝癌者，CT平扫病灶多呈等密度，因此，肝硬化、脂肪肝怀疑肝癌者，CT平扫后再做CT增强以减少等密度肝癌的漏诊。

Objective：To investigate the examination step and diagnostic value of CT for diagnosis of isodense liver cancer. Methods.. Analyses were made on 13 cases with isodense liver cancer first by CT plain scan without obviously abnormal findings and then by CT contrast enhancement scan. Results.① Among the 13 cases,9 cases had hepatocirrhosis,2 cases had fatty liver and 2 cases had hepatitis 13. All had no tumor density on CT plain scan. 2 cases were found having slight local bulging. 2 cases having circular figure in low density with a diameter from 2～3cm. There was no difference between the density in the circle and that in other parts of liver. ② Tumors with different densities could be found in all cases by CT contrast enhancement scan. There were 10 multiple lesions with a diameter from 0.5 ～ 4cm, and 2 solitary cases with a diameter from 2 ～ 3cm. Conclusion.. Hepatocirrhosis, fatty liver merged with liver cancer often show isodensity on CT plain scan. In order to prevent misdiagnosis, we should perform enhanced scan after plain CT scan in such cases.