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目的 研究弥漫型脂肪肝中残留的局灶性正常密度的肝组织 (FSA)的CT特征 ,并讨论它与肝肿瘤的鉴别。方法 回顾性分析 17例弥漫型脂肪肝 (包括肿瘤患者 8例 )中共 2 4个FSA的CT平扫和增强表现 ,3例作了肝穿刺活检 ,其余病例均经过B超或CT追踪复查 1～ 3年 ,FSA大小及形状无明显变化。结果 多数FSA呈典型CT表现。CT正确诊断FSA2 0例和误诊FSA4例 ,其中 3例FSA的部位及形态不典型呈结节状 ,境界清楚 ,位于肝Ⅱ段和Ⅷ段 ,动脉期强化明显 ,延迟期稍有强化。结论 弥漫型脂肪肝中的典型FSA ,CT可以正确诊断 ;少数不典型FSA者 ,CT诊断较困难 ,必要时肝穿刺活检。
Objective To investigate the CT features of focal, normal-density liver tissue in diffuse fatty liver and to discuss its association with liver tumors. Methods The CT findings and enhancement of 24 FSA in 17 patients with diffuse fatty liver (including 8 patients with cancer) were analyzed retrospectively. Three patients underwent liver biopsy and the others were followed up for 1 ~ 3 years, FSA size and shape no significant change. Results Most FSA showed typical CT findings. CT correctly diagnosed 0 cases of FSA2 and 4 cases of misdiagnosed FSA, 3 cases of FSA showed irregular nodules and atypical nodules, located in the liver Ⅱ and Ⅷ, the arterial phase was significantly enhanced, the delay is slightly enhanced. Conclusions The typical FSA and CT in diffuse fatty liver can be correctly diagnosed. In a small number of patients with atypical FSA, CT diagnosis is more difficult and liver biopsy is necessary if necessary.