细菌性肝脓肿的CT、MRI影像诊断及鉴别诊断

目的探讨细菌性肝脓肿的CT及MRI影像学特征,提高对细菌性肝脓肿的诊断率和鉴别诊断水平。方法回顾性分析30例经穿刺细菌培养诊断或临床手术病理证实的细菌性肝脓肿的CT和MRI表现,其中15例经CT平扫和增强检查,11例经MRI平扫和增强检查。其余4例同时经CT,MRI平扫检查和增强检查。结果共34个病灶其中单发病灶27例,多发病灶3例。增强CT 24个病灶脓肿壁表现为病灶边缘极轻或轻度环状强化,肝脓肿在MRI平扫T2WI上表现为高信号,而在T1WI上表现在稍低信号。灌注成像上时间-信号曲线呈"速升-缓升"样变化,脓肿壁时间-信号曲线表现为渐进性强化。结论 CT、MRI影像能较好地显示细菌性肝脓肿的特征,若注意发现和抓住影像学特征,可以提高诊断准确率。

Bacterial Liver Abscess of CT,MRI Imaging Diagnosis and Differential Diagnosis

Objective To analyze the CT and MRI appearances of bacterial liver abscess for the purpose of early diagnosis and differential diagnosis.Methods 30 patients with bacterial hepatic abscess that were confirmed by clinical manifestations and puncture.15 lesions underwent CT plain scan and enhanced scan, 11 lesions underwent MRI plain scan and enhanced scan, another 4 lesions underwent CT and MRI plain scan and enhanced scan. Results There are multiple lesions in 3 cases and single in 27 cases in total 34 lesions. During postcontrast arterial phase EBHA lesions appeared a series of characteristic signs which comprised transient hepatic attenuation difference （THAD） in postcontrast arterial phase, ＂floral cluster＂ signs or ＂honey comb＂ signs in portal venous phase, and ＂gradual filling＂ signs in selayed phase. EBHA lesions were hyperintensity on precontrast MRI T2WI and slight hypointensity on T1WI. on perfusion images, time-signal curve（TSC） appeared as quick heighten-slow heighten pattern. Abscess wall time-signal curve（TSC） appeared as progressive enhancement.Conclusion CT and MRI radiology imaging is a good method of diagnosis and differential diagnosis of BLA.