Liu P, Daneman A, Stringer D A
J Can Assoc Radiol. 1985 Dec;36(4):296-300.
We reviewed the investigation of liver masses in 45 children. Plain films of the abdomen (in 42) and radionuclide liver and spleen scans (in 38) were nonspecific, although the latter had a sensitivity of 100%. Sonography detected lesions in 39 of the 40 patients in whom it was performed (sensitivity 97.5%), and suggested a specific diagnosis in 16 (41%). Computerized tomography (CT) detected all lesions (sensitivity 100%) and gave more information than the other modalities in 17 of the 38 cases (44.7%), as well as the best definition of the extent of liver lesions. Sonography should be the initial modality of choice in children with suspected liver masses but, in most patients, CT is the single most helpful method for defining the extent of such masses. In addition, CT may also show extrahepatic disease. In a particular clinical context, the characteristic CT pattern of contrast enhancement is diagnostic of hemangioma. Angiography provides a preoperative map of abdominal vasculature in patients with malignant disease or vascular aneurysm, and is indicated for this purpose.
我们回顾了对45例儿童肝脏肿块的调查。42例进行了腹部平片检查，38例进行了放射性核素肝脾扫描，结果均无特异性，尽管后者的敏感性为100%。40例接受超声检查的患者中，39例检测到病变（敏感性97.5%），其中16例（41%）提示了特异性诊断。计算机断层扫描（CT）检测到了所有病变（敏感性100%），在38例中的17例（44.7%）中提供了比其他检查更多的信息，同时对肝脏病变范围的界定最为清晰。对于疑似肝脏肿块的儿童，超声应作为首选的初步检查方法，但在大多数患者中，CT是确定此类肿块范围最有帮助的单一方法。此外，CT还可能显示肝外疾病。在特定的临床情况下，CT增强造影的特征性表现可诊断血管瘤。血管造影可为患有恶性疾病或血管动脉瘤的患者提供术前腹部血管分布图，为此目的而进行该项检查。
