一过性异常强化.docVIP

苏州大学学报(医学版)2008；28(5) 增强动态 CT 扫描动脉期肝实质一过性异常强化的临床意义 高回青 1， 范国华 2， 郭 亮 3 （1.苏州市相城人民医院放射科,江苏苏州 215131;2.苏州大学附属第二医院影像科,江苏苏州 215004; 3.苏州大学附属第一医院影像中心,江苏苏州 215006) 摘要:目的 探讨增强动态 CT 扫描动脉期肝实质一过性强化(THPE)的病理基础及其临床意义。 方法 回顾性分 析 90 例 THPE 患者，均先行 CT 平扫，分别于注射对比剂后 30 s、65 s、3~5 min 行动脉期、门静脉期、延迟扫描，分析 THPE 出现部位、形态、各期强化表现及其与肝内外病变的关系。 结果 90 例中，51 例与肝内病变有关，THPE 位于病 灶周围相应叶段或相邻叶段；39 例与肝外病变有关,THPE 以门静脉、肝静脉阻塞和肝动脉-门静脉分流多见，常见相应 肝动脉不同程度增粗。 THPE 形态与病变性质的关系：肝细胞癌（HCC）、胆囊炎/癌以多形态型多见；肝血管瘤、肝内胆管 细胞癌、胰腺癌/炎、门静脉系栓塞/压迫以扇型多见；肝脓肿以叶/段型、扇型多见；肝转移癌可出现扇型、多型态型和弥 漫型；肝内胆管炎、肝硬化、Budd-Chiari 综合征多为弥漫型。 结论 THPE 可见于多种病变，根据其出现部位、形态特征 对了解病变的病理基础和病变定性具有重要的临床意义，有助于选择合理的治疗方案。 关键词：肝脏； 体层摄影术； X 线计算机； 对比增强； 动态； 局部血流 中图分类号：R814.42 文献标识码:A 文章编号:1673-0399(2008)05-0807-04 ClinicalSignificanceofTransientHepaticParenchymalEnhancementin HepaticArterialPhaseDuringDynamicContrast-enhancedCTExamination GAO Hui-qing1, FAN Guo-hua2, GUO Liang3 (1.Dept of Radiology, People’s Hospital of Xiangcheng, Suzhou City, Jiangsu Suzhou 215131, China; 2.Dept of Radiology, the Second Hospital Affiliated to Soochow University, Jiangsu Suzhou 215004, China; 3.Imaging Center, the First Hospital Affiliated to Soochow University, Jiangsu Suzhou 215006, China) Abstract: Objective To assess the clinical significance of transient hepatic parenchymal en- hancement (THPE) in the hepatic arterial phase during dynamic contrast-enhanced CT examination and investigate the pathogenesis of THPE. Methods Ninety cases with THPE were analyzed retrospective- ly. After plan CT scan was done, the enhanced CT scan was respectively performed in the hepatic arte- rial phase(30 seconds after the contrast injection), the portal venous phase(65 seconds after the contrast injection) and delayed phase(3~5 minutes after the contrast injection). The location, shape and enhance- ment feature of THPE were analyzed, as well as the relationship between THPE and lesions in liver was. Results In 90 patients, THPEs were related to hepatic lesions in 51 cases in which the THPEs located next t