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目的:探讨肝转移瘤双期动态增强扫描的CT征象。方法:应用螺旋CT对67例肝转移瘤病人分别进行平扫、增强后肝动脉期和门静脉期扫描,观察瘤灶双期动态扫描的CT征象。结果:(1)67例中29例肝动脉期瘤灶边缘部出现环形强化,其强化密度高于正常肝,低于主动脉。门静脉期瘤灶边缘部的环形强化范围不扩大,其中27例密度仍可高于或等于正常肝,2例密度低于正常肝。(2)67例中22例肝动脉期和门静脉期瘤灶边缘部和瘤内均无明显强化,密度低于正常肝。(3)67例中7例肝动脉期瘤灶出现全瘤均匀性或不均匀性强化,密度高于正常肝;门静脉期瘤灶密度下降,密度等于或低于正常肝。(4)67例中8例肝动脉期多发的肝转移瘤中,一部分瘤灶出现全瘤均匀性或不均匀性强化,或边缘部环形强化,密度高于正常肝;门静脉期密度下降至等于或低于正常肝。另一部分瘤灶则动、门脉双期均始终未见强化。结论:肝转移瘤CT双期动态增强扫描的主要征象是:(1)动脉期瘤灶边缘部出现密度高于正常肝的环形强化,门静脉期此环形强化范围无扩大,密度仍高于或等于正常肝。(2)双期扫描瘤灶均无强化,呈低密度。(3)双期扫描部分瘤灶强化,另一部分瘤灶则始终未见强化。
Objective: To explore the CT signs of dynamic contrast-enhanced scanning in liver metastases. Methods: Sixty-six patients with hepatic metastatic tumors were scanned with plain and enhanced hepatic arterial phase and portal vein phase using spiral computed tomography (CT). RESULTS: (1) In the 67 cases, annular enhancement occurred in the margin of hepatic arterial phase tumors, and the enhancement density was higher than that in the normal liver and lower than the aorta. The annular enhancement of the edge of the portal vein tumor was not enlarged. The density of 27 cases was still higher than or equal to that of normal liver, and the density of 2 cases was lower than that of normal liver. (2) In the 67 cases, 22 cases of hepatic arterial phase and portal vein tumor had no obvious enhancement in the edge and in the tumor, and the density was lower than that in the normal liver. (3) Seventy-seven of the 67 patients with hepatic arterial phase lesions showed uniform or heterogeneous enhancement of the tumor, and the density was higher than that of normal liver; the density of portal vein tumors decreased, and the density was equal to or lower than that of normal liver. (4) Of the 67 cases with hepatic metastases with multiple hepatic arterial phases, some tumors showed uniform or inhomogeneous enhancement of the tumor, or annular enhancement at the margin, and the density was higher than that of normal liver; the portal vein phase density decreased to equal Or lower than normal liver. The other part of the tumor tumor was still no enhancement in both the arterial and portal vein phases. Conclusions: The main signs of double-phase dynamic contrast-enhanced CT scan in liver metastases are: (1) The annular density at the edge of the arterial phase lesion is higher than that of the normal liver, and the annular enhancement of the portal vein phase has no expansion and the density is still higher than or equal to Normal liver. (2) The two-phase scan tumors were not enhanced and showed low density. (3) Part of the double-phase scan enhanced the tumor focus, while the other part of the tumor tumor remained unchanged.