多层 CT 表现的肝脏左叶一过性肝衰减差异：一项回顾性研究。

Multislice Computed Tomographic Manifestation of Transient Hepatic Attenuation Difference in the Left Lobe of the Liver: A Retrospective Study.

机构信息

Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China.

Department of Radiology, The First Affiliated Hospital of Zhongshan University, Guang Zhou, 510080, Guangdong, People's Republic of China.

出版信息

Adv Ther. 2020 Sep;37(9):3954-3966. doi: 10.1007/s12325-020-01428-5. Epub 2020 Jul 26.

DOI:10.1007/s12325-020-01428-5

PMID:32715380

Abstract

INTRODUCTION

Transient hepatic attenuation differences (THAD) are areas of high parenchymal enhancement observed during the hepatic arterial phase on computed tomography (CT). THAD in the left lobe of the liver can lead to surgical complications.

METHODS

A retrospective study was conducted on patients who underwent multislice computed tomography (MSCT) examination of the upper abdomen to understand the morphology, distribution, and causes of THAD and their correlation with hepatic artery variation.

RESULTS

Among 179 cases, 65 and 114 belonged to diseased and normal groups, respectively. THAD as observed in MSCT demonstrated various shapes: lobe/segment (127 cases; 70.9%), irregular sheet (31; 17.3%), strip shape (9; 5.02%), arc/semicircle (7; 3.9%), and segment + flaky (5; 2.79%). THAD were found to be caused by liver tumor (32.3%), hepatic inflammatory lesions (6.15%), biliary tract diseases (13.8%), perihepatic disease compression (9.23%), portal vein obstructive disease (1.53%), and lesion in left hepatic lobe with hepatic artery variation (29.2%). THAD exhibited variation in distribution in the left lobe of the liver. Among 114 cases, THAD in 18 (15.7%) cases were observed in the S2 segment, six (5.26%) in the S3 segment, and 90 (78.9%) in multiple segments of the liver, that is, 50 cases in S2 and S3 segments and 40 cases in S2, S3, and S4 segments. The hepatic artery of 179 cases was of various types based on Hiatt classification: 57 cases of Hiatt I (31%), 65 cases of Hiatt II (37%), 11 cases of Hiatt III (6%), 17 cases of Hiatt IV (10%), 7 cases of Hiatt V (4%), 12 cases of large left hepatic artery (7%), 6 cases of right hepatic artery originating from the celiac trunk (3%), and 4 cases (2%) of superior mesenteric artery originating from the celiac trunk.

CONCLUSION

THAD can occur as a result of specific pathological causes and hence should be considered as a diagnostic sign in liver pathologies.

摘要

介绍

在 CT 上，肝动脉期可见到一过性肝衰减差异（THAD），即肝实质高增强区域。左叶肝 THAD 可能导致手术并发症。

方法

对 179 例接受多层 CT（MSCT）上腹部检查的患者进行回顾性研究，了解 THAD 的形态、分布、原因及其与肝动脉变异的关系。

结果

在 179 例中，65 例和 114 例分别属于病变组和正常组。MSCT 观察到的 THAD 有多种形态：叶/段（127 例；70.9%）、不规则片状（31 例；17.3%）、条状（9 例；5.02%）、弧形/半圆形（7 例；3.9%）和段+片状（5 例；2.79%）。THAD 的原因是肝肿瘤（32.3%）、肝炎性病变（6.15%）、胆道疾病（13.8%）、肝周疾病压迫（9.23%）、门静脉阻塞性疾病（1.53%）和肝左叶病变伴肝动脉变异（29.2%）。左叶肝的 THAD 分布有变异。114 例中，18 例（15.7%）S2 段有 THAD，6 例（5.26%）S3 段有 THAD，90 例（78.9%）多段肝有 THAD，即 50 例 S2 和 S3 段，40 例 S2、S3 和 S4 段。根据 Hiatt 分类，179 例肝动脉类型如下：Hiatt I 型 57 例（31%）、Hiatt II 型 65 例（37%）、Hiatt III 型 11 例（6%）、Hiatt IV 型 17 例（10%）、Hiatt V 型 7 例（4%）、大左肝动脉 12 例（7%）、6 例来自腹腔干的右肝动脉（3%）和 4 例来自腹腔干的肠系膜上动脉（2%）。