Kutllovci Arben, Ymeri Halit, Zogaj Drita, Kutllovci Skender, Zogaj Dukagjin
University Clinical Center of Kosova, Prishtina, Kosova; Faculty of medicine, University of Prishtina, Prishtina, Kosova.
Faculty of medicine, University of Prishtina, Prishtina, Kosova; National Institute of Public Health of Kosova, Prishtina, Kosova.
Acta Inform Med. 2016 Feb;24(1):25-9. doi: 10.5455/aim.2016.24.25-29. Epub 2016 Feb 2.
The liver is the biggest human abdominal parenchymal organ; it weights approximately 1500 grams and is located in the right hypochondrium, under the diaphragm. Liver is able to perform multiple functions also by means of the rich dual vascularization: hepatic arterial system and the portal vein system, between which exists a short circuit (shunt) and free mixture inside the sinusoid, whilst the two flows drain in the same vein system. The discovery of CT and its application in practice fundamentally changes the importance of diagnostic methods for hepatobiliary lesions.
During a 4-year period, 984 patients suspected with liver or biliary tract disease were explored with CT. 117 of these patients were analyzed with liver metastases. Examinations of the liver was performed in dorsal decubitus and in absolute apnea with spiral movement of the table and in denominations of 1and 5 mm. Siemens MSCT 64 and 6 tier apparatuses enable short scanning time with almost immediate reconstruction, which offers all the necessary elements required for carrying out certain protocols.
The average density of metastatic lesions is about 20 HU smaller than normal liver parenchyma. Metastasis with necrosis are more hypodense (30-50 HU smaller than normal liver parenchyma), whilst necrotic metastases with smaller dimensions are almost isodense with normal parenchyma. However, metastases with diameter between 4 to 6 cm are completely isodense and will remain so even after the application of I.V. contrast. The average more frequent size according to most authors, as well as according to our material (148 patients or 90%) was 2-3 cm in transversal diameter.
肝脏是人体最大的腹部实质器官；其重量约为1500克，位于右季肋区，膈下。肝脏还能够借助丰富的双重血管供应来执行多种功能：肝动脉系统和门静脉系统，二者之间存在短路（分流），且在肝血窦内可自由混合，而这两股血流汇入同一静脉系统。CT的发现及其在实践中的应用从根本上改变了肝胆病变诊断方法的重要性。
在4年期间，对984例疑似肝脏或胆道疾病的患者进行了CT检查。其中117例患者接受了肝转移瘤分析。肝脏检查在仰卧位进行，扫描时患者绝对屏气，检查床做螺旋运动，扫描层厚分别为1毫米和5毫米。西门子64层MSCT和6层设备扫描时间短，几乎能立即重建图像，可提供执行特定方案所需的所有必要元素。
转移瘤的平均密度比正常肝实质约低20HU。伴有坏死的转移瘤密度更低（比正常肝实质低30 - 50HU），而较小的坏死性转移瘤与正常实质几乎等密度。然而，直径在4至6厘米之间的转移瘤完全等密度，即使静脉注射造影剂后仍保持如此。根据大多数作者以及我们的资料（148例患者，占90%），转移瘤最常见的横向直径平均为2 - 3厘米。
