结肠癌肝转移瘤的不同CT增强类型影像特征分析

Imaging analysis of different types of liver metastases of colorectal carcinoma with CT contrast enhancement scan

目的：总结CT增强扫描所见结肠癌肝转移病灶CT表现，探讨少见类型的特征表现，以提高对结肠癌肝转移的进一步认识。方法回顾性分析经我院检查确诊的结肠癌肝转移病例共80例177个病灶。所有患者接受16排CT常规三期增强扫描，对图像进行分析。结果177个转移灶中：CT增强表现环状强化者93灶，占52.5%；表现为结节状强化者56灶，占31.6%；表现为车轮征、丝瓜瓤征、钙化性牛眼征者28灶，占15.9%。环形强化的特征为外壁光滑，内壁毛糙，壁厚薄不均，为0.2～8mm,平均1.8mm，壁强化不均。结论结肠癌肝转移CT强化主要表现为环状强化和结节状强化，但也有部分转移瘤影像表现较特殊，其强化有一定的特征表现可与其他病变鉴别，这些特征有助于提高诊断的准确性，减少误诊率。

Objective To summarize the imaging features of colon carcinoma liver metastasis by CT contrast enhancement and discusses rare manifestation of the lesions. Methods 177 liver metastatic lesions from colon carcinoma in 80 patients were retrospectively analyzed using three phase enhanced CT scanning. The imaging features of the various lesions were summarized. Results Among the 177 metastatic lesions,93 annular enhanced ones, accounting for 52.5%,56 focal nodular enhanced ones,accounting for 31.6%,and wheel sign,loofah sign, calcified bull eye sign,accounting for 15.9%,were respectively found. The annular enhanced lesions are characterized by smooth outer walls and rough inner walls. The uneven walls, which thickness being between 0.2-8mm（average 1.8mm）,were heterogeneous enhanced. Conclusion Most liver metastatic lesions of colon carcinoma demonstrate annular and nodular enhanced on CT images. While some lesions show special features, they have some special enhanced characteristics different from other liver lesions,which might be helpful to improve diagnosis accurate rate.