多层螺旋CT在不典型肝脓肿诊断及其与肝癌鉴别诊断中的有效性探讨

The Effectiveness of Multilayer Spiral CT in the Diagnosis of Atypical Liver Abscess and Its Differential Diagnosis from Liver Cancer

目的:探究多层螺旋CT在不典型肝脓肿诊断及其与肝癌鉴别诊断中的有效性。方法:选取2018年2月~2022年2月本院肝胆外科收治的40例不典型肝脓肿患者作为观察组;同期选择30例肝癌患者作为对照组。两组患者均经病理确诊,均行多层螺旋CT检查,并比较其结果。结果:观察组的平扫密度、静脉期密度均明显高于对照组,其动脉期、延迟期密度均明显低于对照组(P<0.05)。观察组的环壁完整率、环内低密度率、灌注异常率、肝内胆管/肝动脉/门静脉异常率均显著高于对照组,其向心性延迟强化率显著低于对照组(p<0.05)。不典型肝脓肿的CT平扫显示其病灶密度不均、内部模糊、边缘模糊,增强后病灶提示“簇状”征象,静脉期CT显示脓肿边缘有明显的强化显像,平衡期CT显示等密度影,且病灶范围较早期明显缩小,肝癌患者则未见这种征象。结论:多层螺旋CT能够有效鉴别诊断不典型肝脓肿和肝癌。

Objective:To investigate the effectiveness of multi-slice spiral CT(MSCT)in the diagnosis of atypical liver abscess and differential diagnosis of liver cancer.Methods:From February 2018 to February 2022,40 patients with atypical liver abscess were selected as observation group,and 30 patients with liver cancer were selected as control group.All the patients were diagnosed by pathology and examined by msct,and the results were compared.Results:The plain scan density and venous phase density of the observation group were significantly higher than those of the control group,while their arterial and delayed phase densities were significantly lower than those of the control group(P<0.05).The observation group showed significantly higher rates of wall integrity,intrauterine low-density,perfusion abnormalities,and intrahepatic bile duct/hepatic artery/portal vein abnormalities compared to the control group,with significantly lower rates of centripetal delayed enhancement compared to the control group(P<0.05).The CT plain scan of atypical liver abscess shows uneven density,blurred interior,and blurred edges of the lesion.After enhancement,the lesion indicates a"clustered"sign.The venous phase CT shows obvious enhancement imaging at the edge of the abscess,while the balanced phase CT shows isodensity shadows.Thelesion area is significantly reduced compared to the early stage,and this sign is not observed in liver cancer patients.Conclusion:Multi-slice spiral CT can differentiate atypical liver abscess from liver cancer.