A study on the transient hepatic abnormal enhancement in the hepatic arterial phase during dynamic contrast-enhanced spiral CT
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1005-1201.2003.03.015
- Key Word:
- 肝,疾病;局部血流;体层摄影术,X线计算机
Abstract： 目的研究肝脏螺旋CT动态增强扫描时肝动脉期肝实质一过性异常强化(transient hepatic abnormal enhancement, THAE)的表现特征,探讨其产生原因及临床意义.方法 1999年1月至2001年9月926例患者因各种原因接受了肝脏或上腹部螺旋CT扫描.CT扫描常规先作全肝或上腹部螺旋CT平扫;注射对比剂开始后25～30 s行肝动脉期扫描,65～70 s行门静脉期扫描;对部分病例还行病灶局部延迟扫描,延迟时间为3、5及10～15 min.肝动脉期共检出82例(男72例,女10例;年龄26～78岁)具有THAE,着重对其在平扫和增强各期图像上的表现、与肝内或肝外病灶的关系以及门静脉系统情况做详细观察和记录.结果 82例(8.9%)共有122处肝动脉期THAE,其中110处(90.2%)平扫未显示THAE区域密度异常,12处(9.8%)呈稍低密度;所有122处THAE在肝动脉期都为均匀的高密度影;在门静脉期,109处(89.3%)转为等密度而不能分辨,余13处(10.7%)为均匀稍高密度影(其中10处作了延迟扫描,均转为等密度).83处(68.0%)THAE呈边缘光滑的楔形或扇形,29处呈不规则形(23.8%),余为其他形状.THAE紧贴肝内肿瘤或其他病灶的有46处(37.7%),邻近肝外肿瘤或其他病灶20处(16.4%),余56处(45.9%)远离肝内、肝外肿瘤或其他病灶.29例(50处THAE)见门静脉主干或左支或脾静脉因各种原因受侵(包括癌栓或血栓形成)或(和)受压而明显变窄或显示不清,这50处THAE以位于肝左叶为多见(P<0.01),且可呈整个段或叶分布.结论 THAE在肝脏螺旋CT动态增强扫描肝动脉期可能经常遇到.其表现多具有特征性.THAE产生原因有多种.正确认识和识别THAE,对提高肝脏或肝外疾病的诊断准确性、避免不正确的活检或治疗有重要意义.
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