CT多期增强扫描对肝脓肿的诊断价值

MULTIPHASIC CONTRAST-ENHANCED CT SCAN IN THE DIAGNOSIS OF HEPATIC ABSCESS

目的探讨CT多期增强扫描对肝脓肿的诊断价值。方法回顾性总结经临床证实39例肝脓肿病人的CT平扫及多期增强扫描表现,分析其CT特点。结果CT平扫39例均呈低密度或稍低密度,其中17例病灶中心可见更低密度影。增强扫描39例均呈环形强化,且环光滑完整,其中13例呈单环强化,26例呈多环强化。动脉期脓肿壁明显强化,呈高密度,炎性反应带未强化,呈低密度。静脉期脓肿壁强化程度减弱,呈略高密度,炎性反应带强化,呈等密度。延迟期脓肿壁仍有强化,保持稍高密度,而炎性反应带呈低密度。三期扫描中脓肿腔内的液化坏死区均未强化。结论CT多期增强扫描对肝脓肿的诊断具有特征性,且较准确。

Objective To assess the value of multiphasic contrast-enhanced CT （MCE-CT） in the diagnosis of hepatic abscess. Methods A retrospective summary was done of MCE-CT manifestations in 39 patients with liver abscess. Results Plain scan： the lesions showed low density or slightly-low density in all 39 cases, in which, much lower density was seen in the centre of the focus in 17 of them. In enhancement scanning, a ring-shaped reinforcement was shown in all cases, the shape was smooth and intact, in which, 13 being helices and 26 polynucleation-enhancement. In arterial phase, the walls of abscess obviously enhanced with high density, and the inflammatory-reaction zone did not, which appeared as low density. In venous phase, the walls of abscess showed decreased reinforcement with slightly higher density, the reaction zone was enhanced with isodensity. In lag phase, the reinforcement of the walls of abscess remained with slightly high density, and low density seen in reaction zone. In three-phase scanning, no enhancement was seen in areas of liquefy and necrosis in vomica. Conclusion Multiphasic contrast-enhanced CT scan is specific and accurate in detection of liver abscess.