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目的探讨肝脓肿增强动态CT扫描时动脉期肝脏实质短暂强化(THPE)的病理基础及其临床意义。方法回顾性分析行增强动态CT扫描的肝脓肿病例43例,均常规先行平扫,分别于注射对比剂后30s、65s和3～5min行动脉期、门静脉期和延迟扫描,分析THPE发生率、部位、形态和各期强化表现。结果43例中,动脉期有28例出现THPE,发生率65%。28例共有脓肿36个,出现THPE36处,表现为动脉期出现肝叶/段形(占31%)、扇形(占50%)、不规则形(占14%)或弥漫形(占5%)强化,门静脉期/延迟扫描与正常肝实质呈等密度。肝脓肿THPE以叶/段形、扇形多见(81%)。结论肝脓肿THPE常以叶/段形、扇形多见,提高对THPE征象的认识,对了解病变的病理基础、病变定性,尤其是化脓性炎症期、脓肿形成初期的不典型肝脓肿的诊断和鉴别诊断具有重要作用。
Objective To investigate the pathological basis and clinical significance of hepatic abscess enhancement dynamic arterial phase transient hepatic stepping (THPE) during dynamic CT scanning. Methods Forty-three cases of hepatic abscess with dynamic contrast-enhanced CT scan were retrospectively analyzed. All patients underwent conventional plain scan. The arterial phase, portal vein phase and delayed scan at 30s, 65s and 3 ~ 5min after injection of contrast medium were respectively analyzed. Location, shape and period of enhanced performance. Results Among the 43 cases, THPE occurred in 28 cases during the arterial phase and the incidence rate was 65%. There were 36 abscesses in total of 36 cases, which showed THPE36, with hepatic lobe / segment (31%), fan (50%), irregular shape (14%) or diffuse shape (5% Intensification, portal venous / delayed scan and normal liver parenchyma was equal density. Liver abscess THPE leaf / segment shape, fan-shaped more common (81%). Conclusions THPE of liver abscess usually has leaf / segment shape and fan shape more common, which improves the understanding of signs of THPE. It is helpful to understand the pathological basis of lesions, qualitative and pathological changes of liver abscess, especially the diagnosis of atypical liver abscess in abscess formation stage Differential diagnosis has an important role.