肝胆常见疾病的CT诊疗.ppt

肝胆常见疾病的CT诊疗;肝胆常见疾病的CT诊断;本节主要内容;肝、胆检查前准备;检查前准备;扫描技术;35s;;;肝脏病变的影像诊断;正常肝脏影像;;正常肝脏的CT平扫表现;正常肝脏的CT增强表现;思 考;肝脏基本病变;肝脏的基本病变;肝脏病变诊断的要点;肝脏常见占位性病变;Case;Arterial phase;Case;Pre-contrast;男，49岁，体检发现肝占位1周;A 73-year-old female complained of recurrent right epigastric pain of 10 years duration;Case;Arterial phase;男，36岁，体检发现肝占位;原发性肝细胞癌;病理分型;病理特点;CT平扫表现;CT增强常见表现;CT增强表现;Arterial phase;中低分化肝癌，肝硬化;;;;中低分化肝癌并坏死;中低分化肝细胞癌并坏死;肝癌伴坏死及癌栓形成;肝癌坏死并癌栓形成;肝动脉-门静脉瘘;门脉海绵状变性;肝细胞-胆管细胞癌并胆管癌栓形成;结节型肝癌;Pre-contrast;男,56岁,体检发现右肝占位,HBsAg阳性,甲胎蛋白阴性;男，68岁，体检发现肝占位1个月;男,54岁,体检发现左肝占位,HBsAg 阳性；α-FP 阴性;;Arterial phase;Hypovascullar hepatocarcinoma;a;中分化肝细胞癌;F,24岁，右上腹痛伴消瘦 2个月 ;弥漫型肝癌;肝癌的诊断要点;肝内胆管细胞癌Intrahepatic Cholangiocarcinoma;Intrahepatic cholangio- carcinoma (ICC);Mass-forming ICC;病理特点;A 42-year-old female complained of right upper quadrant discomfort for 3 months;Delayed enhancement;A 41-year-old female presented with yellow colouration of skin and eyes, and dark coloured urine of one month duration ;A nodule of the right lobe of liver was found in a 63-year-old female on health examination;A mss was found in the left liver in a 66-year-old male on health examination. AFP(-);;A 65-year-old presented with yellowish colouration of the eyes for 3 days;A 73-year-old female complained of recurrent right epigastric pain of 10 years duration;ICC的诊断要点;肝母细胞瘤;M 1岁 上皮型肝母细胞瘤;M 12岁 肝母细胞瘤;转移性肝癌;转移途径;CT平扫及增强表现;;metastases;metastases;胰腺癌肝转移;甲状腺癌肝转移;鼻咽癌肝转移; 肝脏海绵状血管瘤;病理基础;CT表现;CT增强表现;Your diagnosis ？;;;;海绵状血管瘤并出血;;肝细胞局灶性结节性增生 (Focal nodular hyperplasia, FNH);病 理;CT表现;;;FNH;病例1. 男，28岁，体检发现??肝占位1周，HBsAg(+),AFP（－）;;男，36岁，体检发现肝占位;肝细胞腺瘤;肝细胞腺瘤(hepatic adenoma);;pseudocapsule;男，57岁，乙肝8年，发现肝占位3天，AFP（-）;HCC、FNH及CH增强趋势图;肝脏孤立性坏死结节;女，29岁，体检发现肝占位2天;男，43岁，体检发现左肝占位，HBsAg及甲胎蛋白均阴性;男,45岁,体检发现右肝后叶占位,HBsAg阴性,α-FP阴性;男,60岁,体检发现右肝结节影;诊断要点;血管平滑肌脂肪瘤;肝囊肿;背景;CT表现;多囊肝、多囊肾;肝囊肿;鼻咽癌肝转移;Hepatobiliary cystadenoma肝胆管囊腺瘤;;;;;;;cystadenocarcinoma;肝胆管囊腺癌;诊断要点;肝脓肿;病 理;CT平扫表现;CT增强表现;;;;肝脓肿;;;;肝区痛2天;男，68岁，发热2天，肝功异常1天;;;男，32岁，反复发热2周，