肝脓肿的CT诊断

CT diagnosis of hepatic abscess

目的探讨肝脓肿的CT特征，提高诊断准确性。方法搜集我院经临床证实的有完整CT检查资料的肝脓肿15例，男9例，女6例，年龄29～72岁，平均52．2岁。所有病例均经CT平扫和增强扫描。结果15例共20个病灶，单发脓肿13例，多发病灶2例。20个肝脓肿中，11个平扫表现为肝内低密度、边缘模糊的占位病变，6个脓肿内含气体，伴周围胆管积气，3个为多房脓肿。多期动态增强扫描，表现为脓肿周边强化者15个，多环状强化2个，蜂窝状强化3个。结论肝脓肿在CT平扫及增强扫描像上具有特征性表现，CT增强扫描，特别是多期动态扫描可进一步提高肝脓肿的诊断准确性。

Objective To discuss the CT features of hepatic abscess（HA） and to elevate the diagnostic accuracy. Methods Fifteen patients （9 men and 6 women, aged 29-72 years, mean age, 52.2 years） with clinically proved HA were collected in our hospital. All patients underwent CT scans of the abdomen before and after the administration of contrast medium. Results CT scans demonstrated that, there were 20 HA lesions in 15 patients, those comprised 13 single HA in 13 eases and 7 multiple HA in 2 eases. On unenhaneed CT images of 20 HA lesions, 11 lesions appeared as intrahepatic space-occupying loci with low density and ill-defined margin, 6 lesions contained gas, and 3 lesions were muhilocnlar abscesses. On muhiphasic dynamic enhanced CT images of 20 HA lesions, 15 lesions appeared as periphery enhancement, 2 lesions were polyeyelic-form enhancement, and 3 lesions were honeycombing enhancement. Conclusion Hepatie abscess has characteristic appearance, while contrast-enhanced CT scanning, especially muhiphasie-dynamie enhanced CT scanning, may further elevate the diagnostic accuracy of this disease.