论早期不典型肝脓肿CT诊断和鉴别诊断.docx

论早期不典型肝脓肿CT诊断和鉴别诊断 【摘要】目的：探讨早期不典型肝脓肿的CT特 征、表现及鉴别诊断。方法：回顾分析临床病理证实的10 例不典型肝脓肿的CT资料，右上腹疼痛3例，发热2例、 呕吐1例，乏力1例，白细胞计数升高5例，肝功能异常2 例，病灶以外均无异常。结果：不典型肝脓肿具有特殊性， 如能采用CT扫描可以明显地显示出肝脓肿的部位，密切结 合病史、临床、化验，有助于早期肝脓肿的鉴别和诊断。结 论：不典型肝脓肿与肝癌、血瘤相比具有特殊性，采用CT 扫描后明显地显示出病灶位置，为临床治疗不典型肝脓肿提 供有力依据。 【关键词】不典型；肝脓肿；CT表现；鉴别诊断 The CT Diagnosis and Differential Diagnosis of Early Dtypical Liver Abscess/YAN Hai-ping.//Medical Innovation of China, 2013, 10 (35)： 080-081 [Abstract】 Objective： To investigate the early atypical CT features of hepatic abscess, performance and differential diagnosis. Method : Retrospective analysis of CT data of 10 cases of atypical hepatic abscess confirmed by clinical pathology was done, t here were 3 cases of righ t upper quadra nt pain, fever 2 cases, one case of vomiting, fatigue and one case, white blood cell count increased five cases, two cases of abnormal liver function, the lesions showed no abnormality out side. Result： Aty pical hepatic abscess was unique, if they can used CT scans, which could clearly showed the site of liver abscess, closely combined w ith t he his to ry, clinical, labora to ry, to the early identification and diagnosis of liver abscess. Conclusion： Atypical liver abscess and liver cancer, blood tumor, compared with particularity， the use of CT scan show significant lesion location, combine with the diagnostic methods for the clinical treatment of atypical hepatic abscess provide a strong basis? [Key words 】 Atypical ； Liver abscess ； CT manifestations； Differential diagnosis First-author^ s address： Guanyun County Hospital of Traditional Chinese Medicine, Guanyun 222200, China doi： 10. 3969/j. issn. 1674-4985.2013.35.038 肝脓肿是临床一种常见的疾病，是由于细菌、真菌等多 种微生物引起的，典型肝脓肿由于有中央均匀液化坏死区、 病灶周边”双靶征”及病灶内积气等特征性CT表现，诊断 不难，不典型肝脓肿因缺乏上述CT特点，脓肿内常同时存 在多灶性液化坏死区和未完全液化的实性结构而难以鉴别。 近年来，由于抗菌素的广泛使用，肝脓肿病例逐渐增多，但 是其CT也往往缺乏典型肝脓肿表现，很容易被误诊成小肝 癌，小血管瘤等。为了正确认识发现早期不典型肝脓肿，本 文回顾性分析10例不典型肝脓肿的CT表现及鉴别诊断，将 CT图像资料与手术病理所见一一对照分析，总结其特征，以 提高诊断与鉴别诊断水平。 1资料与方法 1. 1 一般资料 本组共10例，其中男8例，女2例。年 龄23?41岁，平均36岁，病