Klasen J, Heusner T A, Riegger C, Reichelt D, Kuhlemann J, Antoch G, Blondin D
Institut für Diagnostische und Interventionelle Radiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
Radiologe. 2011 Aug;51(8):671-9. doi: 10.1007/s00117-010-2125-3.
Computed tomography (CT) is now widely available and represents an important and rapid method for the diagnostics of acute liver disease, characterization of focal liver lesions, planning of interventional therapy measures and postintervention control. In recent years CT has not become less important despite the increasing value of magnetic resonance imaging (MRI). By the use of different contrast medium phases good characterization of space-occupying lesions can be achieved. For the diagnostics of hepatocellular carcinoma (HCC) a triphasic examination protocol should always be implemented. The introduction of dual energy CT increased the sensitivity of imaging of hypervascularized and hypovascularized liver lesions and by the use of virtual native imaging it has become possible to avoid additional native imaging which reduces the x-ray exposition of patients. Positron emission tomography (PET) has an advantage for imaging in oncology because nearly the complete body of the patient can be screened and this is the main indication for PET/CT (whole-body staging). For purely hepatic problems 18F-fluorodeoxyglucose (FDG)-PET/CT using diagnostic CT data has a higher precision than CT alone but is inferior to MRI.
计算机断层扫描(CT)如今已广泛应用,是诊断急性肝病、鉴别肝脏局灶性病变、规划介入治疗措施及进行干预后复查的重要且快速的方法。近年来,尽管磁共振成像(MRI)的价值不断提升,但CT的重要性并未降低。通过使用不同的造影剂期相,可很好地鉴别占位性病变。对于肝细胞癌(HCC)的诊断,应始终采用三相检查方案。双能CT的引入提高了对肝脏富血供和乏血供病变成像的敏感性,并且通过使用虚拟平扫成像,得以避免额外的平扫成像,从而减少了患者的X线照射。正电子发射断层扫描(PET)在肿瘤成像方面具有优势,因为几乎可以对患者的整个身体进行筛查,这也是PET/CT(全身分期)的主要适应证。对于单纯的肝脏问题,使用诊断CT数据的18F-氟脱氧葡萄糖(FDG)-PET/CT比单纯CT具有更高的精度,但不如MRI。