肝脏肉芽肿CT表现及病理分析.docVIP

肝脏肉芽肿CT表现及病理分析作者单位：475003 河南开封市肿瘤医院（徐新胜）；河南开封市儿童医院（朱笑年） 通讯作者：徐新胜 【摘要】 目的 探讨肝脏肉芽肿的早期和晚期CT表现并与病理对照分析，进一步提高对本病的认识和诊断的准确性。方法 对31例经手术病理证实的肝脏肉芽肿进行回顾性分析，全部行上腹CT平扫、动态增强扫描。结果 肉芽肿早期病灶，平扫为边缘模糊的低密度灶，形态可为圆形、花瓣型、索条形，增强动脉期不均匀强化或明显强化，持续至门脉期、延迟期有逐渐增加的趋势。31例肝脏肉芽肿共35个病灶，其中9个为早期肉芽肿。纤维化期平扫示边界清晰的低密度灶，形态为圆形、卵原形等，增强无明显强化或边缘环状强化，31例肝脏肉芽肿共35个病灶，26个为纤维化期病灶。结论 肝脏肉芽肿的多期CT表现可以反映其所处的病理时期，可以与肝脏的其它肿物鉴别。 【关键词】 肉芽肿； 纤维化期； 动态增强 CT of the liver granulomas and pathological analysis of the performance XU Xin-sheng*,ZHU Xiao-nian.*Kaifeng Cancer hospital in Henan Province,Kaifeng 475003,China 【Abstract】 Objective To investigate the early and late stages of liver granuloma CT and pathologic analysis of performance and further enhance the awareness of this disease and diagnostic accuracy.Methods 31 patients with pathologically proved liver granuloma were analyzed retrospectively,all OK abdominal CT scan,dynamic contrast-enhanced scans.Results Early granuloma lesions,plain low-density lesions at risk ambiguity, shape can be round,petal type,cord bar,enhanced arterial phase enhancement or uneven obviously enhanced and sustained to the portal phase,latency period is gradually increasing trend.31 cases of liver granuloma lesions were 35,including nine of early granuloma.The fibrotic stage of the boundary scan clear low-density lesions,morphology round,egg prototype so as to,enhance the edge of no significant enhancement or rim enhancement,31 cases of liver granulomas were 35 lesions,26 for the fibrotic stage lesions.Conclusion Of the multi-phase CT hepatic granuloma may reflect their performance in the period in which the pathology can be identified with the liver and other tumor. 【Key words】 Granuloma； Fibrosisfhase； Dynamiccontrast-enhanced 肝脏肉芽肿是多种病因引起的伴有肉芽肿形成的局限性慢性炎症，是一种少见的肿瘤样改变。近年来有逐渐增多的趋势。在超声及普通CT上缺乏特征性，容易被误诊。而在多期螺旋CT增强扫描的表现有一定特征。综合分析可以帮助医生做出正确诊断。现搜集笔者所在医院经病理证实的肝脏肉芽肿患者31例，对其CT征象加以分析总结并与病理对照，以提高此类病变诊断的准确性，报告如下。 1 资料与方法 1.1 一般资料 共收集本院2000年10月～2008年10月间经手术和（或）病理证实的肝脏肉芽肿31例共35个病灶，其中