早期肝脓肿CT动态增强与MR影像分析

Clinical analysis of dynamic enhanced CT and MR image for early liver abscess

目的探讨早期肝脓肿患者的CT动态增强和MR影像特征，为早期肝脓肿的诊断及治疗提供有效依据。方法选择2011年6月至2013年5月晋中市第二人民医院收治的60例早期肝脓肿患者为研究对象，分别进行CT动态增强扫描和MR平扫，总结其病变分期、范围、病因、形态、强化方式等资料。结果60例早期肝脓肿患者中多发45例，单发15例。平扫表现出“大水肿、小脓腔”征象，增强扫描为“簇状”征象，逐渐强化，衰减延迟。脓肿囊腔的簇状或融合发生率（82．23％）明显高于恶性肿瘤囊腔的簇状或融合发生率（12．85％），差异有统计学意义（P〈0．05）；动脉期及静脉期水肿区与正常区密度差异未见统计学意义（P〉0．05）；但延迟期水肿区密度明显高于正常区，差异具有统计学意义（P〈0．05）。结论CT动态增强扫描与MR平扫都具有自由的优势，均能从不同影像学角度显示早期肝脓肿痛变特征，为临床诊断和治疗提供参考。

Objective To investigate the imaging characteristics of dynamic enhanced CT and MR for early liver abscess, and provide effective basis of early diagnosis and treatment of liver abscess. Methods Sixty patients with early liver abscess from June 2011 to May 2013 were selected as study group and treated by dynamic enhanced CT scan and MR scan. The lesions in installment, scope, the cause, form and the way of strengthening materials were analyzed. Results Among the 60 patients with early liver abscess, 45 cases of PLA in the early stage of abscess were multiple, 15 cases were single. Scan showed a ＂big edema, small pus cavity＂ signs, enhanced scan for ＂clumps＂ signs, gradually strengthened and attenuation delayed. The lumen of the abscess tufted or fusion rates （82. 23 % ） was significantly higher than the lumen of the malignant tumor tufted or fusion rate（ 12. 85%, P 〈0. 05）. Arterial and venous phase edema area and normal area density has no significant difference （ P 〉 0.05 ）. But the delay edema area density was significantly higher than normal area （ P 〈 0. 05）. Conclusions Dynamic enhanced CT scan and MR scan has the advantages of freedom, both can display the early liver abscess lesions from the perspective of different imaging characteristics, provide reference for clinical diagnosis and treatment.