脂肪肝背景下肝转移瘤的CT诊断研究

CT Diagnosis of Hepatic Metastases in Fatty Liver

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。

Abstract: 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...