目的 分析肝镰状韧带旁假性病灶（falciform ligament pseudolesion，FLP）与引流静脉的MSCT特征，探讨两者的关系。 方法 回顾性收集2021年10月至2022年10月在我院行肝CT平扫或增强的病人，各96例，评价FLP及引流静脉的显示率和影像学特点。MSCT肝Ⅲ、Ⅳ段引流小静脉分3型：A型，为上下两支，上支起自膈肌与肝之间的脂肪区向下前走行进入肝Ⅲ、Ⅳ段，下支起自脐水平稍上方的前腹壁或局部腹腔脂肪区向上后走行进入肝Ⅲ、Ⅳ段；B型，同A型上支；C型，同A型下支。 结果 CT平扫和增强显示的FLP形态均以楔形为主（57.1%、63.4%），最常见于肝Ⅳ段前内缘（93.8%），增强CT门静脉期FLP显示率最高（42.7%）；CT平扫和增强对FLP的显示差异具有统计学意义（P<0.001），对肝Ⅲ、Ⅳ段引流小静脉的显示差异无统计学意义（P>0.05）；CT平扫病例中有FLP和无FLP引流小静脉的显示率差异无统计学意义（P>0.05），CT增强病例中有FLP和无FLP引流小静脉的显示率差异有统计学意义（P<0.001）；CT增强5例FLP未见引流小静脉显示，29例引流小静脉显示的病例未见FLP。 结论 FLP有一定的CT特征，较易与真性病灶鉴别；MSCT肝Ⅲ、Ⅳ段引流小静脉以C型最常见；CT平扫显示的FLP与肝局部组织学异常有关，与引流小静脉无直接相关性，CT增强显示的FLP与引流小静脉有关，可能由引流小静脉和局部肝实质内血供两种因素共同影响。
Abstract
Objective To discuss the MSCT findings of falciform ligament pseudo-lesion (FLP) and drainage veins, and to explore the relationship between them. Methods An each of 96 patients who received plain and enhanced CT scans in our hospital from October 2021 to October 2022 were retrospectively collected. The main evaluation indicators were image findings and features of FLP and drainage vein. The drainage veins of Ⅲ and Ⅳ segments of liver in MSCT were divided into 3 types: type A, have upper branch and lower branch, the upper branch started from the fat area between the diaphragm and the liver and went forward and down into Ⅲ and Ⅳ segments of the liver, the lower branch started from the anterior abdominal wall or the fat area of local abdominal which slightly above the umbilical level, then moved backward and upward into Ⅲ and Ⅳ segments of the liver; Type B, was the same as the upper branch of type A; Type C, was the same as the lower branch of type A. Results The morphology of FLP was mainly wedge-shaped (57.1%, 63.4%) in both plain and enhanced CT images, and the anterior inner edge of Ⅳ segment of the liver was the most common location (93.8%). The highest detection rate of FLP was found in portal vein phase (42.7%). There was statistically significant difference in the detection rate of FLP between plain and enhanced CT (P<0.001), but there was no statistically significant difference in the detection rate of drainage venules in the Ⅲ and Ⅳ segments of liver (P>0.05). There was no significant difference in the detection rate of drainage venules between with and without FLP in plain CT images (P>0.05), but there was significant difference in the detection rate of drainage venules between with and without FLP in enhanced CT images (P<0.001). No drainage vein was observed in 5 cases of FLP in enhanced CT images, meanwhile no FLP was observed in 29 cases which showing drainage venules. Conclusions FLP is easy to distinguish from true lesions by certain CT features. Type C is the most common type of drainage venules in segment Ⅲ and Ⅳ of liver in MSCT. FLP of plain CT scan has no direct correlation with drainage venules, but associated with local histological abnormality of liver. FLP of enhanced CT scan associated with drainage venules, and was affected by both drainage venules and local blood supply of hepatic parenchyma.
关键词
肝镰状韧带； /
/
假病灶； /
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引流静脉； /
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多层螺旋CT； /
/
增强
Key words
Falciform ligament of the liver; /
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Pseudolesion; /
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Drainage vein; /
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Multi-slice CT /
Contrast-enhancement
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