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本帖最后由 liliya 于 2011-1-13 15:31 编辑
我是2008年六月开始恩替抗病毒治疗的，效果十分好，除了血小板是111b/l 外，其他一切正常。
以下是我最近的CT结果：
Indication：HepatitisB cirrhosis with small nodules in the liver at previous CT. Ultrasounds in the intervl show no masses. Normal AFP.
Triphasic scans of the liver have been performed and compared with the previous from 2008 and with reference the the ultrasound in between.
Contrast administered without adverse reaction.
There is no significant abnormality demonstrated on the nonehanced scan. The liver looks uniform in its attenuation.
On the arterial phase the vascular and hepatic opacification is slightly different from the previous scan which was somewhat more towards a portal venous phase in its opacification than the arterial phase we have today.
There are a number of focal perfusion abnormalities demonstrated in the liver at today's examination. One of these only, peripheral and somewhat poorly defined, almost wedge-shaped abnormality in segment 6 looks very similar to that seen previously and almost certainly represents a perfusion anomaly or possibly a regenerating nodule with surrounding perfusion change.
There is a further enhancing lesion demonstrated in segment 6 measuring 6x5x6mm, not clearly visible in the previous scan but becoming isodense on the portal venous phase. It dose not therefore show clearly a wash-out effect but remains somewhat suspicious and should be referred to on the next followup scan. There is a further poorly-defined 8mm maximum lesion demonstrated posteriorly in segment 6 which has more characteristics of a perfusion anomaly with a slightly low-attenuation, wedge-shaped area peripherally. Again this becomes isodense on the portal venous phase. A more peripheral, less well -defined, hypodense lesion is seen right against the margin of the liver posteriorly in segment 6 which again is almost certainly a perfusion anomaly.
In segment 7, again peripherally, there is a small , brightly enhancing area with a less well-defined zone adjacent which again becomes siodense on the portal venous phase and I think probably is again a perfusion anomaly or possibly a small haemangioma. It really is too difficult to classify. More certrally in segment 7 there is a very small. hypodense area,4mm , again becoming isodense on the portal venous phase.
In segment 4A anteriorly, again there is a small area of increased perfusion with a less well-defined area surrounding it, likely to represent a regenerating nodule or perfusion anomaly.
The spleen is similar in size and appearance to that seen previously and the portal vein has a similar dimension at around 11--12mm. There is no adenopathy demonstrated. The kidneys and pancreas are normal. There is no significant pelvic abnormality demonstrated.
There is a small, enhancing lesion demonstrated low in the pelvis between urethra and rectum on the left which was present previously but because of the timing of the scan, not so well seen and is likely to represent a small vascular anomaly. Its unlikely to be of clinical consequence. Maximum dimension is 12mm.
Summary:
A number of arterial phase perfusion changes have been demonstrated, only one of which was clearly seen on the previous scan from 2008. This is partly due to the slight difference in the timing of the sequences, with today's scan being a very arterial sequence. All of these lesion are small and therefore very difficult to characterise but some have fairly distinctive perfusion anomaly appearances. The lesions of suspicion would be that which is centred slightly more centrally in segment 6 at approximately 6mm, and seg7 at 4mm. These do not, however, show significant wash-out.
At this stage these lesions are probably too small to be further accurately characterised by MRI and ,in the absence of a rise in AFP. followup surveillance with a combination of ultrasound and CT should be continued.
请问411 老师，我需要再做MRI吗？
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发表于 2011-1-13 15:31
