MSCT对肝脏占位性病变鉴别诊断.doc

MSCT对肝脏占位性病变鉴别诊断[摘要] 目的 探讨肝内占位性病变的MSCT鉴别要点。方法 回顾性分析2009.9-2011.9年期间129例肝脏占位性病变的MSCT影像表现。结果 57例肝脏血管瘤中55例平扫为低密度，2例为等密度；其中52例于动脉期边缘呈结节样强化，5例病变呈均匀轻度强化。21例肝细胞癌中平扫19例为低密度，2例为等密度；增强显示动脉期21例病灶明显不均匀强化，门脉期呈明显低密度，低于周围正常肝实质。6例肝内胆管细胞癌，平扫：均表现为肝脏低密度影，边界不清；增强扫描：5例动脉期无明显增强，呈延迟增强；1例早期呈网格状增强，延迟期呈片状增强。30例肝脏转移癌，平扫显示为肝内多发低密度灶，增强扫描显示为不均匀强化。结论 通过控制增强扫描的时间，观察肝脏病变的血供情况，再结合患者各自的临床表现，对肝脏占位性病变做出准确诊断是不难的。 [关键词] 肝脏； 占位性病变； 计算机体层摄影； 鉴别诊断 [中图分类号] R333.4[文献标识码] B[文章编号] 1005-0515（2011）-08-017-02 The Differential Diagnosis of MSCT for the Liver Space-occupying Lesions [Abstract] Objective Explore the identify points of Liver space-occupying lesions.Methods Image performance of 129 patients during 2009.9-2011.9 were retrospectively analyzed. Results In 57 cases of liver hemangioma 55 cases is low density in plain CT scan,and the other two cases are equal density.Of which 52 cases are nodular enhanced, and 5 cases are mild enhanced.19 cases of 21 patients with liver cell carcinoma arelow density in plain scan,and the other two cases are equal density;enhance scan showed that 21 cases are obviously uneven enhanced, in portal phase is significantly lower density,lower than normal surrounding liver parenchyma.6 cases are intrahepatics, plain scan show that is low density,boundary is not clear,Enhance scan showed that 5 cases are not obviously enhanced in artery phase,and is delayed enhanced.One case isperiphery enhance in artery phase,and is patchy enhanced in delay phase.30 cases of liver metastatic carcinoma, plain scan show that multiple low density in liver, enhancement show that focal for not even strengthened.Conclusion Through the control of enhanced time, observation of blood to the liver lesions, combine with the different clinical menifestations of liver space-occupying lesions, to make an accurate diagnosis is not difficult. [Keywords] Liver; Space-occupying lesions; Computer tomography； Differential diagnosis 肝脏占位性病变在临床上并不少见，多数病变可以依据其典型的影像学特征作出诊断，然而有的病变缺乏典型特征，所以要求影像科医生必须深入了解不同