CT examination of liver tumors: the morning fasting patients do scan at 3% in the first half-hour oral gel 200ml meglumine to filling the upper small intestine. Patients with normal supine position, the occasional need to use lateral or prone position, followed by oral 200ml bed to filling the stomach and duodenum. Recently has been the subject of silver meal examination, the need to lock agent to be drained from the gastrointestinal tract can be made after the CT, the scanning process must remain consistent at all levels of breathing. Unenhanced scan and the strengthening of scanning.
1 CT examination of liver tumors. Hepatic benign tumor
(1) hepatic cavernous cancer: Department of the most common benign hepatic neoplasms. Can be found in any age, but more common in adults, more women than men, which can be single, but multiple hemangiomas very common more than 90% can be diagnosed by CT. When the performance of plain round or oval low-density lesions, the realm of clear, smooth or slightly lobulated shape. Most of uniform density, but a considerable number, especially large hemangioma, in the center more visible irregular low-density areas, CT values between 4,7 _10HU. Calcification of a small number of centers, not seen on plain and primary liver cancer, liver cancer or other benign difference. After rapid injection of contrast agent within 60 seconds, low-density edge of hemangiomas appear scattered, highly dense enhanced lesions, and enhance the density of lesions of the aorta with the same level are equal, over time, gradually expanding the scope of enhancing lesions, the density decreases, even relatively small lesions prone to enhance the performance of this gradual expansion, which is an important diagnostic indication of hepatic hemangioma.
(2) liver cell adenoma: Since the incidence rate after the promotion of oral contraceptives increased significantly. The CT showed a clear round low-density block of the border, a few showed equal density. After injection of contrast agent significantly increased dollars. If the tumor after hemorrhage occur within low-density scan is the equivalent of fresh bleeding in high-density areas. Showed low density areas of old hemorrhage, CT findings due to lack of characteristic features, which require the application of various imaging studies.
(3) liver cyst: This is a common congenital disease, can be single, multiple, or the formation of numerous cysts polycystic liver polycystic liver and can with or without polycystic kidney disease. CT showed a smooth shape, low-density state clearly the circular lesions around the thin, was linear, uniform density of capsule contents, no housing distribution phenomenon, the value of unenhanced CT between the 0_20HU. General scan can be confirmed. Special circumstances required for the differential diagnosis, can be enhanced CT scans. After injection of contrast medium CT value of the same capsule, the surrounding normal liver tissue contrast enhancement is more clear.
CT examination of liver cancer 2. Malignant liver tumors feet
(1) Primary liver cancer: conventional plain first, because most of the scan can confirm the diagnosis, and after injection of contrast medium is likely to result in some foci density becomes so missed. Plain when the vast majority of liver cancer for the low-density or low density or low density lesion with equal density, high-density mixed nodules. Be emphasized that liver cancer and the density of the surrounding normal liver was little difference, and thus narrow the window must be observed, otherwise missed. Abdomen with a window width 150_250 general picture, and some of the smaller liver required 80, or even a narrow window of 40 to be displayed. Carcinoma of the density is uniform, determined by the size of foci, large foci of necrosis and hemorrhage often occurs due to cystic change, etc., more uniform density, the center is more often low-density areas.
Showed fresh bleeding rare high-density areas. Whether or irregular shape is smooth, but showed a spherical, so the disease should occur at multiple levels. Even if the performance of smaller nodules should also be shaped so that with fatty infiltration or artifact identification. Most liver cancer realm vague, but a small liver cancer, liver cancer nodules and cysts in the realm of clear. As liver pathology complicated, so the performance after the injection of contrast agent is also diverse. Overall, the majority of liver lesions enhanced slightly in the narrow realm becomes clear from the vague. Aikuai dense nodules occur within or across. Moreover, some small low-density lesions, after injection of contrast medium such as the density of the image disappear into, but the duration is short. Some liver after injection of contrast agent does not increase or only slightly increased.
(2) bile duct cancer : most common in the bile duct, but is also found in the hilar hepatic duct and intrahepatic bile ducts. Common symptoms caused by obstruction of yellow disease. Small intrahepatic bile duct cancer outside liver CT showed low density mass in the region, the shape of hepatocellular carcinoma. For example, a large left or right hepatic duct hepatic duct showed the main limitations of the corresponding expansion of the intrahepatic bile ducts.
(3) lymphoma: This rare tumor to the liver as the primary site. Autopsy found that 60% and 50% of Hodgkin's disease non-Hodgkin's lymphoma invasion and liver. CT manifestations of diffuse infiltration of lymphoma diffuse fatty degeneration of the liver similar to the irregular low-density areas, this type were more common; CT findings of nodular lymphoma, multiple low density lesions with side or center of the transfer of primary hepatocellular carcinoma cancer can not be identified.
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