CT三期增强扫描与MRI在诊断肝脓肿中的应用价值对比

Comparison of CT Three-phase Enhanced Scanning and MRI in the Diagnosis of Liver Abscess

目的探讨MRI与CT诊断肝脓肿的影像学特征,比较二者在肝脓肿中的诊断价值。方法选取我院2015年12月-2016年9月收治肝脓肿患者82例,收集患者一般资料、影像学资料等,分析CT增强扫描、MRI扫描对肝脓肿的影像表现特征,比较两种检查方式对肝脓肿的检出率。结果 82例患者中单发者66例(80.48%)、多发患者16例(19.51%),病灶平均直径(5.02±1.79)cm;82例患者在CT平扫中病灶均呈均匀低密度或不均匀的等低混杂密度影,外观形态呈现圆形或类圆形,14.63%(12/82)病灶部分与毗邻组织边界不清,其中部分脓肿周围有低密度水肿带,中央为脓腔,密度不均匀,CT值高于水而低于肝实质;CT增强扫描中,动脉期脓肿壁呈轻度环形强化,脓肿壁周围的水肿带则无强化,63.41%(52/82)环形强化的脓肿壁和周围的无强化的低密度水肿带构成了的"环征";82例患者MRI扫描T1序列中建均呈均匀或不均匀的低信号,周围信号强度介于脓腔和肝实质间,73.17%(60/82)MRI平扫T2WI脂肪抑制序列可见肝脏左外叶分叶状不均匀高信号灶;MRI增强扫描后,脓肿壁呈环形或蜂窝状强化,并可见内有分隔,脓腔中心液化坏死区无强化;MRI扫描对肝脓肿总检出率为96.34%(79/82),明显高于CT三期增强扫描81.70%(67/82)(P<0.05);其中MRI对门静脉源性的肝脓肿检出率显著高于CT三期增强扫描(24.39%vs 12.19%)(P<0.05)。结论 CT三期增强扫描与MRI扫描对肝脓肿对肝脓肿的检出率均较高,联合两种检查方式可有助提高诊断准确率。

Objective To evaluate the imaging features of MRI and CT in the diagnosis of hepatic abscess,and to compare the diagnostic value of both in liver abscess.Methods A total of 82 patients with liver abscess were enrolled in our hospital from December 2015 to September 2016,and the general data and imaging data were collected.The imaging features of CT scan and MRI scan were analyzed.The detection rate of liver abscess.Results Of the 82 patients,66(80.48%)were single,16(19.51%)had multiple patients,and the mean diameter of the lesion was(5.02±1.79)cm.The 82 patients had CT Uniform density of low density or uneven,such as low density density,the appearance of the shape of circular or round,14.63%(12/82)lesions and adjacent tissue boundary is unclear,some of the abscess around the low density of edema,the central For the abscess,the density is not uniform,CT value is higher than the water and lower than the liver parenchyma.CT enhanced scan,the arterial abscess wall was mild ring enhancement,abscess wall edema around the no enhancement,63.41%(52/82)Circular enhancement of the abscess wall and the surrounding non-enhanced low-density edema band formed a"ring sign".82 patients with MRI scan T1 sequence were homogeneous or uneven low signal,the surrounding signal intensity between the abscess And liver parenchyma,73.17%(60/82)MRI scan T2WI fat suppression sequence can be seen in the left lobe of the liver lobulated uneven high signal foci.MRI enhanced scan,the abscess wall was ring or honeycomb enhanced,and visible There is separation,abscess center of liquefaction necrotic area without strengthening The total detection rate of liver abscess was 96.34%(79/82),which was significantly higher than that of CT three-phase enhanced scan(67.70%)(P<0.05).The MRI(24.39%vs 12.19%)(P<0.05).Conclusion CT three-phase enhanced scan and MRI scan have high detection rate of liver abscess in liver abscess,and the combination of two methods can improve the diagnostic accuracy.