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目的 探讨肝癌自发破裂伴腹腔内出血 (血腹 )的CT诊断。方法 回顾分析 2 2例肝癌自发破裂CT表现 ;分析肝癌破裂出血的机制 ;各种CT病理特征及其与肝癌破裂的关系。结果 所有破裂的肿瘤均位于肝脏的周边带 ,12例显示了突出于肝边界外的实质。肿瘤的最大径为 2～ 16cm ,中心坏死 16例。肝表面不连续 16例。 3例“未发现破裂”的肝癌在增强时发现造影剂外溢至肝边界之外。 2例只显示为肿块中出血但手术中发现已发生了破裂。 1例整个肝脏破裂 ,分离的碎块漂浮于大量的腹水中。 5例增强扫描显示了周边带状强化但不连续低密度病灶。结论 CT诊断肝癌自发破裂有很高的精确度 ,对临床怀疑肝癌自发破裂造成血性腹水者 ,CT检查十分必要。
Objective To investigate the CT diagnosis of spontaneous rupture of liver cancer with intra-abdominal hemorrhage (blood-septum). Methods A retrospective analysis of 22 cases of spontaneous rupture of liver cancer CT manifestations; analysis of liver cancer rupture mechanism of bleeding; various CT pathological features and its relationship with the rupture of liver cancer. Results All ruptured tumors were located in the peri-hepatic band, and 12 cases showed parenchymal prominence outside the liver border. The maximum diameter of tumor is 2 ~ 16cm, 16 cases of central necrosis. The liver surface is not continuous in 16 cases. In 3 cases of “undiscovered” liver cancer, the contrast agent was found to spill to the outside of the liver boundary. Two cases showed only bleeding in the tumor but found to have ruptured during the operation. One case of the entire liver ruptured and the isolated pieces floated in a large amount of ascites. Five enhanced scans showed banding around but not continuous low-density lesions. Conclusion CT diagnosis of spontaneous rupture of liver cancer has a high accuracy, clinical suspicion of spontaneous rupture of liver cancer caused by bloody ascites, CT examination is necessary.