脂肪肝的CT诊断.ppt

* 《脂肪肝的CT诊断》 Diagnosis of Fatty Liver on Computed Tomography 江苏省镇江市中医院影像中心CT室 谈 瑞 生 【摘要】 目的 探讨脂肪肝的CT表现特征及其诊断价值。 方法 对47例经确诊的脂肪肝病例作CT检查。测量肝脏CT值，观察肝内血管相对密度的变化。 结果 47例中轻度脂肪肝19例，肝脏平均CT值47Hu（34~59Hu），16例表现为肝血管湮没；中度脂肪肝16例，肝脏平均CT值35Hu（28~40Hu），11例表现为肝血管反转显示；重度脂肪肝12例，肝脏平均CT值12Hu（3~25Hu），均表现为肝血管明显反转显示。其中不典型脂肪肝19例，包括肝岛4例5个灶，局灶性脂肪肝7例，不均匀脂肪肝8例。结论 CT对脂肪肝的诊断具有明显的优越性。 【关键词】 脂肪肝；体层摄影术；X线计算机；诊断 【Abstract】 Objective To study the diagnosis of fatty liver on computed tomography. Methods Forty-seven who were diagnosed as fatty liver were examined by CT. and the attenuation of liver parenchyma were measured . To differentiate the degree of fatty liver, the mean CT value and the relative density of hepatic vessels were observed. Results Among the 47 cases, there were 19 cases of mild steatosis with mean CT number of 47Hu（34～59），16 cases of middle degree fatty liver with mean CT number of 35Hu（28～40），and 12 cases of sever fatty liver with mean CT number of 12Hu（3～25），For the relative density of hepatic vessels, 16 of the 19 cases of mild fatty liver had a appearance of hepatic vessel immersion , 11 of 16 middle degaree cases had reverse hepatic vessels display ,and all the 12 cases of sever steatosis had the appearance of reverse hepatic vessels display with sharp contrast between vessels and the liver parenchyma. There were 19 cases of atypical fatty liver, among them, 4 cases were focal sparing which included 5 foci in the fatty liver, 7 focal fatty infiltration and 8 inhomogeneous fatty liver. Conclusion When diagnosing fatty liver, CT is a good choose. 【Key words】 fatty liver；tomography；X-ray computed；diagnosis 当肝细胞内脂质蓄积超过肝湿重的5％或组织学上每单位面积见1/3以上肝细胞脂肪变性时，称为脂肪肝。随着现代人们生活水平的逐渐提高以及饮食结构的变化，脂肪肝的发病率不断增多。有报道认为[1]脂肪肝发病率可达16％左右。笔者分析47例经临床证实的脂肪肝病例的CT表现，旨在提高CT对脂肪肝病例的诊断价值。 1 材料与方法 1.1 一般资料 本组47例中，男性35例，女性12例。年龄26～70岁，平均年龄39.6岁。肥胖30例，不肥胖者17例；有饮酒史者28例，不饮酒者19例；既往有肝炎病史者4例，出现腹水者2例；有糖尿病史5例；胆囊炎6例；冠心病1例；脑动脉硬化3例。 1.2 临床资料 主要临床表现为上腹部不适、腹胀、食欲减退、四肢乏力及肝区隐痛等，有18例无明显症状；触诊肝肿大16例、压痛14例、合并脾大5例；47例中有血脂升高46例（血甘