论著伴有中央瘢痕的肝脏占位病变的螺旋CT诊断.pdfVIP

中华现代影像学杂志 Journal of Chin ese Modern Imaging 2 007 年第 4 卷 第 3 期 ·197 · ·论 著 · 伴有中央瘢痕的肝脏 占位病变 的螺旋 CT 诊断 张惠娟 [ 摘要] 目的 通过分析肝脏不同性质肿块 内的瘢痕, 探讨肿块 内瘢痕对肝脏肿块的螺旋 CT 诊断和鉴别诊断意义 。方 法 回顾性分析 292 例肝脏肿块, 有 62 例含有瘢痕的肝脏 占位, 其 中局灶性结节增生( FNH ) 31 例, 纤维板层样肝癌( FLHCC) 24 例, 肝血管瘤 13 例。结果 有 62 例含有 中央瘢痕的肝 占位, 伴有 中央瘢痕的FLHCC 和血管瘤往往都较大, 而 FNH 一般 5 cm 。FLHCC 的中央瘢痕典型表现为大而宽、中心性和偏心性, 可 以到达肿块边缘, 增强检查瘢痕无 明显异常强化; FNH 中央 瘢痕薄而小, 动脉期和 门脉期均呈低密度, 而在延时期瘢痕出现强化, 瘢痕影缩 小甚至消失呈等、高密度 。巨大血管瘤 中央瘢 痕呈裂隙样, 大小形态变化较大, 多期动态增强均无 明显异常强化 。结论 在对含有 中央瘢 痕的肝脏肿瘤 的鉴别诊断中, 中 央瘢痕的形态及强化特征对病灶的定性具有非常重要的参考价值 。 [ 关键词] 体层摄影术, 螺旋计算机; 肝; 诊断 [ 中图分类号] R 814 . 4 [ 文献标识码] A [ 文章编号] 16 81 - 2824 ( 2007) 0 3 - 0197 - 03 H elical CT diagn osis of liver lesions with cent r al scar s ZHANG Huijua n. Nanping F irst Hospital , Nanpin g 353000 , Ch ina [ Ab str act ] Obj ect ive To evaluate the h elical computed tomography ( CT) features of central scars in liver le sion s and th eir significan ces in the diagnosis and differential di agnosis of liver lessions. M eth od s CT fin dings of 62 cases of liver lesions with central scars in 292 p atients of liver lesion s were retrosp ectively reviewed . Sixtytwo cases of liver lesion s in cluding focal nodular hyp erp lasias( FNH) ( n = 31) , fibrolamellar h ep atocellular carcinomas( FLH CC) ( n = 24) , and hemangiomas ( n = 13 ) . Resu lt s Of the 62 cases of liver lesions with central scars, FLHCCs and haemangi omas were always larger while FNHs were usually less th an 5 cm in diameter . Typ ical finding of scars in FLHCC were large, central or n oncentral scars which may reach the margin of the lesions and showed n o en h an cement after administration of contrast ; scars in FNHs were usually small and