关键词：癌，肝细胞；超声检查；断层摄影术，X；线计算机；血管造影
【摘要】 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。
Diagnosis of Acute Hemoperitoneum due to Spontaneous Rupture of Hepatocellular Carcinoma: The Clinical and Imaging Characteristics
WANG Tianli FAN Jiadong HUANG Shibing
(Department of Radiology, No.3 Hos pital, Beijing Medical University, Beijing 100083, P.R.China )
【ABSTRACT 】 Objective To investigate the clinical and imaging characteristics of acute hemoperitoneum due to spontaneous rupture of hep atocellular carcinoma (HCC). Materials and Methods The clinical manifestations, and th e radiographic as well as ultrasonic features in 9 patients with hemoperitoneum associated with spontaneous rupture of HCC were analyzed. Results The main clinical manifestations were acute abdom inal pain, hemoperitoneum and hypovolemic shock. Sonogram revealed high-echo ar ea at the bleeding site. Plain CT scans showed high-density blood within the lo w-attenuation tumor area. Hemoperitoneum was characterized by ascites with an i ncreased CT value. On angiography, contrast extravasation was seen (n =1). Conclusion Spontaneous rupture of HCC is a life-threaten ing condition, early diagnosis is urgent in order to save life. For its diagnosi s, CT is more sensitive than sonography, while the angiography is the least sens itive.
【Key words 】 Carcinoma,hepatocellular Ultraso nography Tomography,X-ray computed Angiography
原发性肝细胞癌(hepatocellular carcinoma,HCC)是严重威胁人类健康的疾病 ......
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