肝脓肿的螺旋CT诊断

SCT diagnosis of hepatic abscess

目的:探讨肝脓肿的螺旋CT三期增强扫描诊断特点。方法:分析25例经临床确诊的细菌性肝脓肿的多层螺旋CT平扫及三期增强扫描表现。三期延迟时间分别为25s,60s和120s。结果:肝脓肿增强扫描的典型CT表现为:①动脉期及门脉期灶周正常肝组织出现高灌注征象;②病灶周边和或内部出现单个或多个完整或不完整强化环;③病灶内有宽窄不等的不规则分隔;④灶周低密度水肿带门脉期显示最清晰;⑤延迟期脓肿壁、分隔及水肿带均呈等密度,仅坏死区无强化呈低密度。肝脓肿亦有CT表现不典型者。肝癌可合并肝脓肿。结论:螺旋CT三期增强扫描诊断肝脓肿具有特征性,是必不可少的检查方法。

Objective: To discuss the diagnostic features of hepatic abscess in multislice spiral CT(MSCT) with contrast enhancement(CE). Methods: Analysis of the plain MSCT scanning and 3-phase CE scanning findings of the bacterial hepatic abscess in 25 cases were carried out. All of which were diagnosed clinically. The delay times of the three phases were 25s, 60s and 120s respectively. Results: The typical features of the hepatic abscess in CE examination are as followings: ①High perfusion sign of the normal liver tissue around the lesions in arterial phase and portal phase; ②Single or multiple enhancement rims or rings are in and/or around the lesions; ③Thin or thick irregular septations can be seen in the lesions; ④The edematous zones around the lesions are showed most clearly in the portal phase; ⑤In the delayed phase, the wall, septations and edematous zone of the abscess are all isodense, only the necrotic areas are not enhanced and was hypodense. Some hepatic abscesses have atypical CT manifestations. The hepatic carcinoma can be complicated with the hepatic abscess. Conclusion: Three phase contrast enhancing MSCT scanning is specific in diagnosing hepatic abscess and is an indispensable examination method.