Itai Y, Araki T, Furui S, Tasaka A
J Comput Assist Tomogr. 1981 Dec;5(6):834-42. doi: 10.1097/00004728-198112000-00009.
Differential diagnosis was attempted in 225 cases of hepatic masses using computed tomographic (CT) criteria. Hepatocellular carcinomas were suggested by the presence of an isodense mass, a narrow circular zone surrounding the mass, bulging of the tumor from the hepatic surface, decreased attenuation of an entire hepatic lobe, and diffuse homogeneous enhancement following bolus injection. The presence of liver cirrhosis on CT also favored the diagnosis of hepatocellular carcinoma. More than half the metastatic tumors showed findings rarely encountered in hepatocellular carcinomas, i.e., more than 10 lesions, masses with nodular margins and showing a gradual decrease in density toward the center, multiple calcifications, and peripheral enhancement following bolus injection. All cavernous hemangiomas were correctly diagnosed by serial scanning after bolus injections. Hepatic abscesses also revealed pathognomonic CT findings, while cholangiocarcinoma did not disclose characteristic features. Rapid serial scanning after the bolus injection of contrast medium was very helpful in the differential diagnosis of hepatic masses by CT.
利用计算机断层扫描（CT）标准对225例肝脏肿块进行了鉴别诊断。等密度肿块、肿块周围狭窄的环形带、肿瘤从肝表面隆起、整个肝叶衰减降低以及团注后弥漫性均匀强化提示肝细胞癌。CT上存在肝硬化也有助于肝细胞癌的诊断。超过一半的转移瘤表现出肝细胞癌中很少见的表现，即超过10个病灶、边缘呈结节状且密度向中心逐渐降低的肿块、多发钙化以及团注后周边强化。所有海绵状血管瘤通过团注后的连续扫描均得到正确诊断。肝脓肿也显示出特征性的CT表现，而胆管癌未显示出特征性表现。团注造影剂后的快速连续扫描对CT鉴别肝脏肿块非常有帮助。
