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目的 :分析肝多发性血管瘤及合并肝癌或肝转移瘤的CT表现 ,探讨螺旋CT多期连续扫描在诊断上的优越性。方法 :2 1例患者 ( 16例多发性血管瘤 ,2例肝血管瘤合并原发性肝癌 ,3例肝血管瘤合并肝转移瘤 )。按常规先对全肝进行平扫 ,然后于注射造影剂后 3 0秒、60秒、2分钟、5分钟、10分钟、15分钟后进行肝脏螺旋扫描。结果 :2 1例患者肝脏内病灶数共 75个。血管瘤病灶 66个 ,其中 2 1/ 66小血管瘤病灶平扫时表现为均匀低密度区 ,增强扫描 3 0秒、60秒 ,表现均匀强化 ,或边缘不规则强化 ,2分钟、5分钟、表现高密度或等密度灶 ;10分钟、15分钟 ,表现为等密度灶或低密度灶。 4 4/ 66例大血管瘤 ,增强扫描表现为强化渐向中心扩展 ;1/ 66例大血管瘤 ,5～ 15分钟 ,表现为边缘轻度强化。 2例肝血管瘤合并肝癌 ,肝癌病灶共 2个 ,平扫时为低密度灶 ,增强扫描 3 0秒表现为不均匀强化。 3例肝血管瘤合并转移瘤 ,转移病灶 7个 ,平扫表现低密度。增强扫描 5 / 7个病灶在 3 0秒、60秒表现为周边强化 ,2 / 7个病灶各期呈均匀低密度。结论 :螺旋CT多期动态扫描 ,不仅同时对肝多发性血管瘤做出诊断 ,而且同时对血管瘤合并肝癌或肝转移瘤做出诊断和鉴别诊断
Objective : To analyze the CT features of hepatic multiple hemangiomas combined with hepatocellular carcinoma or hepatic metastases, and to explore the advantages of multi-phase spiral CT in the diagnosis. Methods: Twenty-one patients (16 multiple hemangiomas, 2 hepatic hemangiomas with primary hepatocellular carcinoma, and 3 hepatic hemangiomas with hepatic metastases). Routine hepatic scans were performed routinely before hepatic spiral scans were performed 30 seconds, 60 seconds, 2 minutes, 5 minutes, 10 minutes, and 15 minutes after injection of contrast media. Results : There were 75 lesions in the liver in 21 patients. Hemangioma lesions 66, of which 2 1 / 66 small hemangiomas lesions showed a uniform low-density area during the scan, enhanced scan 30 seconds, 60 seconds, the performance of uniform enhancement, or irregular edge enhancement, 2 minutes, 5 minutes, The performance of high-density or iso-density lesions; 10 minutes, 15 minutes, the performance of iso-density or low-density lesions. In 4/66 cases of large hemangioma, the enhanced scan showed enhanced progressive central expansion; 1/66 cases of large hemangioma, 5 to 15 minutes, showed mild marginal enhancement. Two cases of hepatic hemangioma with liver cancer, liver cancer lesions were a total of 2, low-density lesions when the plain scan, enhanced scan 30 seconds showed uneven enhancement. Three cases of hepatic hemangioma combined with metastases, metastatic lesions 7, plain scan showed low density. On the enhancement scan, 5 / 7 lesions showed peripheral enhancement at 30 seconds and 60 seconds, and 2 / 7 lesions showed uniform low density at each phase. Conclusion :Spiral CT multi-phase dynamic scan not only diagnoses hepatic multiple hemangiomas simultaneously, but also diagnoses and differentially diagnoses hemangiomas combined with hepatocellular carcinoma or hepatic metastases.