教學片6-消化系統(tǒng)3

消化系統(tǒng)（三）溫州醫(yī)學院醫(yī)學影像學系DepartmentofRadiologyWMCDepartmentofRadiologyWMCDepartmentofRadiologyWMCDepartmentofRadiologyWMC肝臟各段的劃分Couinaud&Mercadier肝左葉：尾狀葉（1段）S1外上側段（2段）S2外下側段（3段）S3

內(nèi)側段（4段、方葉）S4肝右葉：前下段（5段）S5

后下段（6段）S6

后上段（7段）S7

前上段（8段）S8DepartmentofRadiologyWMCDepartmentofRadiologyWMCDepartmentofRadiologyWMC肝硬化伴結節(jié)性肝癌DepartmentofRadiologyWMC重度脂肪肝DepartmentofRadiologyWMC肝癌平掃與動脈期增強DepartmentofRadiologyWMC肝癌靜脈期增強表現(xiàn)DepartmentofRadiologyWMC塊型肝癌DepartmentofRadiologyWMC肝癌CT血管成像DepartmentofRadiologyWMC肝癌－MR的T2WI呈混雜高信號腫塊＋假包膜征像T1動脈期混雜強化DepartmentofRadiologyWMCDepartmentofRadiologyWMC肝癌CT特點小結CT平掃：肝內(nèi)低密度灶，邊界清晰，有占位效應，有時可見“假包膜”，腫瘤較大時，中心?？梢姼兔芏葔乃绤^(qū)CT增強：“快進快出”動脈期快速達到峰值，（肝癌多為肝動脈供血）門脈期強化程度快速減退，強化程度低于肝臟實質（肝臟為門靜脈供血）平衡期強化程度繼續(xù)下降DepartmentofRadiologyWMC肝臟血管瘤DepartmentofRadiologyWMC肝血管瘤增強動態(tài)變化DepartmentofRadiologyWMC肝血管瘤：T2顯著較均勻高信號－亮燈征；T1均勻低信號DepartmentofRadiologyWMC肝臟血管瘤的特點CT平掃：肝臟實質內(nèi)圓形或類圓形低密度腫塊CT增強：“兩快一慢”注射速度要快，開始掃描要快，延遲時間要長?！霸绯鐾須w”平掃低密度，增強早期從邊緣開始強化，程度接近同層的大動脈，逐漸向病灶中心擴展，延遲掃描，病灶呈等密度充填。DepartmentofRadiologyWMC肝臟多發(fā)轉移瘤－牛眼征DepartmentofRadiologyWMC肝膿腫－壁強化蜂窩征與暈征DepartmentofRadiologyWMCDepartmentofRadiologyWMC肝包蟲囊腫－水上百合征DepartmentofRadiologyWMCDepartmentofRadiologyWMC肝囊腫：無壁強化的液性密度囊腔DepartmentofRadiologyWMC單純肝囊腫DepartmentofRadiologyWMC多囊肝DepartmentofRadiologyWMCDepartmentofRadiologyWMC“T”管造影—正常膽道解剖

DepartmentofRadiologyWMCERCP顯示正常膽道解剖

DepartmentofRadiologyWMC“T”管造影—膽總管下端結石DepartmentofRadiologyWMC經(jīng)皮肝穿膽造影(PTC)：總膽管結石擴張

DepartmentofRadiologyWMC肝內(nèi)膽管擴張、結石DepartmentofRadiologyWMC膽囊癌：分葉狀腫塊DepartmentofRadiologyWMC鑒