摘要
目的 探讨脂肪肝背景下肝脏转移性肿瘤的CT表现 ,对产生误诊、漏诊的原因进行分析。方法 分析 31例脂肪肝合并转移瘤病人的CT征象 ,全部病例均行CT平扫和增强扫描。结果 发现转移灶共 91个 ,其中单发 13个 ;误诊、漏诊 11个病灶。转移灶表现为高密度结节 4 0个 ,高密度环 12个 ,随脂肪肝程度加重 ,高密度结节或环的比率增高。增强扫描多检出病灶 2 6个。结论 脂肪肝合并肝内转移瘤平扫常表现为高密度结节或环 ,易误诊为肝岛。分析观察高密度结节或环的形态、增强扫描后的密度变化 ,楔形高密度灶的形态、位置、边缘 ,肝缘的轮廓、血管走行、门脉细小分支瘤栓有助于鉴别诊断。增强扫描可以提高脂肪肝内转移瘤的检出率。
Objective To evaluate the manifestations of tumors metastasized in fatty liver by CT and analyze the reasons of misdiagnosis.Methods Thirty-one patients of hepatic metastases with fatty liver, which were proved by operation, biopsy or follow-up were studied.All were performed both non-enhanced and enhanced CT scan.Results Ninety-one metastases lesions were detected, in which 13 were solitary, 11 were misdiagnosis or missed diagnosis, 40 lesions appears hyperdensity nodules, 12 showed hyperattenuating rim on non-contrast CT. The percentage of high-intensity nodules increased with aggravation of fatty liver. Twenty-two additional lesions were detected on enhanced CT.Conclusion Tumor metastasized in fatty liver more often appears to be moderate highdensity nodules or rings, and focal spared areas are the main reason for misdiagnosis. Observation of the shape, attenuate change of the nodules or rings. The configuration, location, margin, course of the vessel, and the existence of tumor thrombus in proximal portal vein of wedge-shaped high intensity areas are helpful for differential diagnosis. Enhanced CT can improve the sensitivity.
出处
《肿瘤防治研究》
CAS
CSCD
2004年第10期604-607,共4页
Cancer Research on Prevention and Treatment
关键词
脂肪肝
转移瘤
体层摄影术
X线计算机
Fatty Liver
Hepatic Metastases
Tomography
X-ray computed
