摘要
目的探讨消化道腺癌肝脏转移灶的多排螺旋CT表现。方法收集36例经病理检查证实为消化道上皮腺癌肝脏转移患者的CT及临床资料,其原发灶包括胃癌10例、十二指肠癌1例、结肠癌18例、直肠癌7例。所有病例均行常规CT平扫及双期增强扫描。重点观察肝内转移灶的各期CT表现。结果36例中有32例(88.9%)在CT平扫图像上表现为多发的大小不等的低密度结节影,3例(8.3%)为单发的低密度结节影,1例为以囊性病变为主的囊实性肿块。CT增强扫描,有4例(11.1%)病灶周边出现动脉期淡薄的环状强化;门静脉期29例(80.6%)表现为病灶边缘部的轻度环状强化,向内为稍低密度环状软组织影,中心区呈更低密度的圆形影,即典型的“牛眼征”;3例(8.3%)动脉期、门静脉期病灶均无强化。结论病灶边缘部在门静脉期的淡薄环状强化,特别是“牛眼征”是消化道腺癌肝转移的特征性CT表现。
Objective To investigate the CT imaging features of metastatic hepatic adenocarcinomas from the digestive tract by using multi-detector-row helical CT （MDCT） with pathological correlation. Methods CT and clinical data of 36 patients with pathologically proven metastatic hepatic adenocarcinomas from the digestive tract were retrospectively reviewed. The primary tumors included 10 cases of gastric cancer, 1 duodenal cancer, 18 colonic carcinoma, 7 rectal cancer. All patients underwent MDCT plain scan and contrast-enhanced dual-phase scanning of upper or whole abdomen. The appearances of hepatic metastatic lesions on MDCT images at various enhancement phases were carefully observed. Results On plain CT scan 32 cases （88. 9%） presented multiple nodules of low density at different sizes, 3 cases （8.3%） showed a single low-density nodule, and 1 case presented with a cystic mass. On contrast-enhanced scan, 4 cases （11. 1%） showed faintly enhanced rim around the nodules on arterial phase; on portal venous phase 29 cases （80.6%） presented slight ring-like enhancement at the periphery of the nodule while the nodule core was markedly hypodense with intermediate soft tissue density area in between, giving rise to the typical appearance of “bull＇s-eye” sign. Three cases （8. 3 % ） showed no enhancement on either phase images. Conclusion The ring-like enhancement and the appearance of “bull＇s-eye” on portal venous phase was characteristic CT features of metastatic hepatic adenocarcinoma from digestive tract.
出处
《中国普外基础与临床杂志》
CAS
2005年第5期518-520,共3页
Chinese Journal of Bases and Clinics In General Surgery
