目的 探讨CT动态增强与MRI在 肝脓肿病理分期诊断中的临床价值。方 法 回顾性分析我院2013年8月-2015年12 月期间收治并经手术病理证实的81例肝脓 肿患者的一般临床资料及影像学资料，观 察比较肝脓肿CT动态增强扫描和MRI扫描 的影像表现特征，对其病变分期、病因、 范围、形态以及强化方式进行总结分析。 结果 本组81例患者中单发67例、多发14 例；肝脏脓肿位于肝肝右叶49例、肝左 叶25例、同时侵犯左右肝脏7例；病灶的 直径在1cm~13cm之间；CT动脉期表现为脓 肿壁强化程度高于正常肝实质，炎性反应 带无强化；门静脉期脓肿壁强化程度降 低，其密度略高于正常肝实质密度，炎性 反应带强化，呈等密度改变；延迟期脓肿 壁仍有强化，其密度稍高于正常肝实质密 度，炎性反应带呈低密度，3期扫描中脓 腔中心液化坏死区均未见明显强化；MRI 平扫病灶主要表现为T1呈均匀或不均匀的 低信号，T2表现极高信号，增强扫描后， 脓肿壁呈环形或蜂窝状强化，分房的脓肿 间隔也出现强化，液化区无明显强化。结 论 联合应用螺旋CT动态增强扫描和MRI扫 描，在对肝脓肿病理分期临床诊断中达到 优势互补的目的，能够提高诊断准确率， 降低误诊率，值得临床诊断中进一步推广 与应用。

Objective To investigate the clinical value of CT dynamic enhancement and MRI in the diagnosis of liver abscess. Methods Retrospective analysis of the general clinical data and imaging data of 81 patients with liver abscess confirmed by surgery and pathology in our hospital from August 2013 to December 2015. Observation and comparison of CT dynamic enhanced scan and MRI scan imaging features of liver abscess. Summary and analysis of the pathological stage, etiology, scope, form and strengthening methods are summarized and analyzed. Results In this group, 81 cases were solitary in 67 cases and multiple in 14 cases. The abscess was located in the right lobe of the liver in 49 cases, the left lobe of the liver in 25 cases, and the left and right liver in 7 cases. The diameter of the abscess was between 1cm~13cm. CT features of arterial phase into the abscess wall strengthening degree higher than that of normal liver parenchyma and inflammatory reaction with no enhancement; portal venous phase abscess wall enhancement degree decreased, the density slightly higher than normal liver parenchyma and inflammatory reaction with enhanced were density changes; delay abscess wall is enhanced and the density is slightly higher than that of normal liver parenchyma, inflammatory reaction with a low density, the liquefactive necrosis of pus cavity center showed no obvious enhancement in all the 3 phases scanning. MRI plain scan lesions mainly showed T1 is homogeneous or inhomogeneous low signal, T2 is very high signal, the abscess wall was ring or honeycomb enhancement, distribution of abscess interval to strengthen, liquefied area without obvious enhancement. Conclusion Combined with the application of spiral CT dynamic enhancement scan and MRI scan and in the pathology of liver abscess stage clinical diagnosis achieve complementary advantages, can improve the diagnostic accuracy rate, reduce the misdiagnosis rate. It is worthy of clinical diagnosis in the further promotion and application.