Objective To explore the typical features of hepatic abscess on precontrast CT scans and its diagnostic values. Methods Precontrast and arterial and portal phase scanning were conducted using a Ge BrightSpeed 16 MDCT scanner in 76 patients with clinically proven hepatic abscess (39 males and 37 females; median age 60. 5 years; range, 2 to 89 years). All precontrast images were retrospectively analyzed by 2 experienced radiologists. Then,CT findings were compared. Results Precontrast CT showed both segregation and stratification of lesions in 15 patients, segregation in 27, stratification in 7, low density lesions without significant segregation and stratification in 22, and gas-containing abscess in 8. Enhanced scan showed both segregation and stratification of lesions in 26 patients, segregation in 28, stratification in 10, low density lesions without significant segregation and stratification in 4,and gas-containing abscess in 8. A definite or probable diagnosis was made in 41 patients (54%) on precontrast CT images. All lesions containing gas and the most lesions with segregation and stratification signs were correctly diagnosed as hepatic abscess. Conclusion About half of patients with hepatic abscess have characteristic findings on precontrast CT. The typical features may clearly suggest the diagnosis of hepatic abscess.%目的 探讨肝脓肿的CT平扫表现及其诊断价值.方法 76例临床证实的肝脓肿患者纳入研究,其中男39例,女37例,年龄2～89岁,中位60.5岁.采用GE BrightSpeed 16层螺旋CT机完成平扫、动脉期和门脉期扫描.两位有经验的放射科医生先共同回顾性分析所有平扫图像,然后对照分析所有图像进行比较.结果 CT平扫同时显示的分隔和分层15例,仅有分隔27例,仅有分层7例,仅显示低密度灶而无明显分隔或分层表现22例,病灶内含气体8例;增强扫描显示同时分隔和分层26例,仅有分隔28例,仅有分层10例,仅显示低密度灶而无分隔或分层表现仅4例,病灶内含气体8例.明确诊断或倾向性较强诊断41例(占54%),所有含气体的、同时有分隔和分层显示的全部明确诊断.结论 约半数肝脓肿的CT平扫表现有特征,典型表现可以明确提示肝脓肿的诊断.
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