目的 探讨不典型肝脓肿与肝癌的鉴别诊断。方法 通过对7例初诊为肝癌的患者入院后复查CT以及全面完善各项检查、详询病史等,总结分析,对两者进行鉴别。结果 不典型肝脓肿患者多具有发热史且抗生素治疗有效,AFP阴性、乙肝病毒携带率以及肝硬化病发率均较低等特征,尤其延期复查CT的4例患者均表现出了肝脓肿的蜂房状改变,即簇形征,避免了手术损伤。结论 除了病史、检验等相关提示外,对于无法确诊的肝占位患者,在治疗允许的情况下,延迟复查CT(距初次检查约2周左右)对两者的鉴别诊断有比较重要的意义。

Objective To investigate the differential diagnosis between atypical hepatic abscess and hepatocellular carcinoma.Methods CT reexamination after admission, other tests, and medical history were comprehensively analyzed for differential diagnosis in seven patients newly diagnosed with liver cancer.Results Atypical liver abscess patients had a history of fever, effective antibiotic treatment, AFP negative, low hepatitis b virus carrier rate, and low cirrhosis rate.In particular, all the four patients who delayed the CT reexamination showed hive-like change of liver abscess, namely the cluster-like sign, thus avoiding surgical injury.Conclusion In addition to the data of medical history and examination, it is of great significance to delay the reexamination of CT (about two weeks after the initial examination) for the differential diagnosis of undiagnosed liver occupying lesions if the treatment allows.