弥漫型脂肪肝的假肿瘤征CT诊断

CT Diagnoses of Pseudotumor in Diffuse Fatty Liver

目的 研究弥漫型脂肪肝中残留的局灶性正常密度的肝组织 (FSA)的CT特征 ,并讨论它与肝肿瘤的鉴别。方法 回顾性分析 17例弥漫型脂肪肝 (包括肿瘤患者 8例 )中共 2 4个FSA的CT平扫和增强表现 ,3例作了肝穿刺活检 ,其余病例均经过B超或CT追踪复查 1～ 3年 ,FSA大小及形状无明显变化。结果 多数FSA呈典型CT表现。CT正确诊断FSA2 0例和误诊FSA4例 ,其中 3例FSA的部位及形态不典型呈结节状 ,境界清楚 ,位于肝Ⅱ段和Ⅷ段 ,动脉期强化明显 ,延迟期稍有强化。结论 弥漫型脂肪肝中的典型FSA ,CT可以正确诊断 ;少数不典型FSA者 ,CT诊断较困难 ,必要时肝穿刺活检。

Objective\ To study CT finding of focal spared areas (FSA)in diffuse fatty liver and differentiate from liver tumor. Methods To analyze retrospectively CT finding of 24 FSA before and after contrast-enhansement in seventeen patients which including eight tumor patients,three of them proven by liver biopsy and the rest patients by follow-up with US or CT showed no changes in size and shape of FSA in one to three years. Results CT findings of most FSA in diffuse fatty liver were typical and were diagnosed correctly.Three of four FSA in diffuse fatty liver that were misdiagnosed for tumor on CT imagings,with atypical location and shape,showed enhancement on CT during arterial phasic and delay phasic imagings. Conclusion Typical CT finding of FSA in diffuse fatty liver were diagnosed correctly,and it was necessary for liver biopsy in the rare atypical cases if CT diagnoses of FSA were difficult. [