不典型肝脓肿的CT诊断(附10例分析)

CT Diagnosis of Atypical Hepatic Abscess: Analysis of 10 Cases

目的：探讨不典型肝脓肿（AHA）的CT表现特征，着重讨论其与肝癌（HCC）的鉴别诊断问题。材料与方法：将10例己证实的不典型肝脓肿CT图像与手术病理所见及同期证实的一组肝癌CT图像对照分析，10例均无病灶周边"双靶征"及病灶内均匀液化坏死和积气等典型肝脓肿CT表现。结果：不典型肝脓肿多为早期肝脓肿，平扫CT表现无特征性；增强扫描可见：（1）周边多囊征；（2）边缘锐利征；（3）蜘蛛征；（4）持续强化征。结论：上述4个征象是不典型肝脓肿特征性CT表现，掌握此4个特征，不典型肝脓肿的诊断与鉴别诊断不难。

Objective: The CT features of AHA were studied to differentiate atypical hepatic absess (AHA) from hepatocellular carcinoma (HCC). Materials and Methods: The CT and operative-pathologic findings of 10 cases with AHA were analyzed and compared with the CT appearences of a series proven cases of HCC. None of 10 cases had the so-called typical findings such as the marginal 'Double-target sign' and the even liquidizing necrotic area, and containing gas zone within the lesion. Results: Most of AHA are early hepatic abscess, and the precontrast CT showed nonspecific features. There were four characteristic features on contrst CT, they were: (1 )peripheral multicyst sign; (2)sharp-edged sign; (3)spider-like sign; (4)continued enhancement sign. Conclusion: The authors believed that the above mentioned characteristic features are very valuable for the diagnosis of AHA and the differential diagosis from HCC.