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目的 探讨原发性肝癌 (HCC)自发性破裂出血的临床特点及影像学表现。材料与方法 根据 9例HCC自发性破裂继发腹腔内出血临床表现 ,结合超声、CT、血管造影征象进行分析。结果 HCC自发性破裂出血临床主要表现为急性上腹部疼痛、腹腔内出血、失血性休克。超声检查主要显示HCC出血部位出现高回声区。CT扫描显示HCC出血区出现高密度影 ,腹腔内出血表现为腹腔积液CT值增高。血管造影显示肿瘤血管破裂区出现对比剂外溢。结论 影像诊断敏感性CT高于超声 ,血管造影最低。HCC自发性破裂继发腹腔内出血是威胁患者生命的临床急症之一 ,早期正确诊断是治疗的基础。
Objective To investigate the clinical features and imaging findings of spontaneous ruptured hemorrhage in primary liver cancer (HCC). Materials and Methods According to the clinical manifestations of 9 cases of spontaneous rupture of HCC secondary to intra-abdominal hemorrhage, ultrasound, CT, and angiographic signs were analyzed. Results The main clinical manifestations of spontaneous rupture of HCC were acute upper abdominal pain, intra-abdominal hemorrhage and hemorrhagic shock. Ultrasound examination mainly showed high echo area at the site of HCC bleeding. CT scans showed high-density shadows in the hemorrhagic area of HCC, and intra-abdominal hemorrhage showed an increase in the CT value of peritoneal effusion. Angiography revealed a contrast agent spill in the tumor vessel rupture zone. Conclusion The diagnostic sensitivity of CT imaging is higher than that of ultrasound, and the angiography is the lowest. The spontaneous rupture of HCC secondary to intra-abdominal hemorrhage is one of the clinical emergencies that threaten the lives of patients. Early correct diagnosis is the basis of treatment.