肝脏转移瘤的CT表现与病理分析

CT manifestation and pathological analysis of hepatic metastases.

探讨肝脏转移瘤的CT表现及病理基础。对28例肝脏转移瘤的CT资料进行回顾性分析。28例肝脏转移瘤中,原发灶来源于消化道肿瘤的较多。瘤灶多发者22例(78．6％),以右叶及全肝弥散分布多见,多数为圆形或类圆形病灶,大部分边界清楚,大小差异较大,直径在(1～3)cm之间居多。低密度病灶21例(75％);单纯低密度者5例,中心见更低密度者4例,出现“瞳孔”征1例,“牛眼”征4例,“圈饼”征2例,“囊样坏死”征2例,“壁结节”征2例,“液-液面”征1例。高密度病灶6例(21．4％);瘤内出血2例,瘤内钙化2例,在脂肪肝基础上呈相对高密度2例。等密度1例(3．6％)。强化方式呈多样性,边缘性强化具有特征性。常伴随其它病变。肝脏转移瘤CT表现多样,但具有一定的特征性,只要我们结合临床,分析其病理特点,大多可明确诊断。

To discuss the CT manifestations and pathological basic of the hepatic metastases. CT radiographs of 28 patients with hepatic metastases were studied respectively. Many cases were metastasized from gastrointestinal neoplasms among the 28 cases. 22 cases （78. 6% ） had two or more metastatic lesions that spread in the hepatic parenchyma, especially in right lobe. Most lesions appeared as round or round - like with clear margin. The size of lesions were variable and mostly varied from lcm to 3cm. Lesions of 21 cases showed low density （75%）, among which 5 cases showed lesions in simple low density, 4 cases lesions in relative law density at the center. 1 cases showed pupil sign, 4 cases bull eye sign, 2 cases pie sign, 2 cases cystic necrosis sign, 2 cases wall nub sign and 1 case fluid - fluid level sign. Lesions of 6 cases showed high density （21.4%） , among which 2 cases were intratumoral bleeding, 2 cases intratumoral calcification and 2 cases with fatty liver relative high density. 1 case showed isodensity （ 3.6% ）. The enhancement patterns were variable. And most of marginal enhancement was characteristic. The hepatic metastases lesions were often accompanied by other lesions. The CT manifestation of hepatic metastases was muhiformity. But they had some definite characters. An exact diagnosis of hepatic metastases can mostly be made through the combination with clinical sign and analyzing the pathological trait.