肝脏孤立性坏死结节与肝脏炎性假瘤MRI鉴别及意义

The role of MRI in diffentiat diagnosis between Isolated Necroic Nodule and Inflammatory Psedotumor of liver

目的:探讨肝脏孤立性坏死结节与肝脏炎性假瘤MRI表现的不同之处。材料与方法:收集7例肝脏孤立性坏死结节、5例肝脏炎性假瘤临床及MRI资料,以上病例均经手术病理证实。结果:1、部分肝脏孤立性坏死结节MRI表现为T1及T2WI上分别呈低信号及等信号,另各有1例T2WI混杂信号,及略高信号,增强后病灶内部无强化,部分病灶(3/7)有细环状轻度延迟强化的包膜。2、肝脏炎性假瘤MRI表现为:T1WI呈低或等低信号,T2WI为略低信号(4/5)或略低信号内夹杂小斑片状高信号(1/5),增强门脉期及延迟期,病灶强化方式有①边缘部强化明显,中心强化弱(3/5)②不均匀强化,边缘欠清(1/5)。结论:MRI平扫加动态增强能很好的鉴别肝脏孤立性坏死结节与肝脏炎性假瘤,尤其对肝脏孤立性坏死结节具有高度诊断特异性,并指导临床治疗方案的制定。

Purpose:To disscuss the diffent in manifestations of MRI between isolated necrotic nodle and inflammatory pseudotumor of liver.Materials and Methods:The clinical and MRI data were collected,the diagnosis for all of 12 patients was confirmed by operation and parhology,7 cases and 5 cases suffered isolated necrotic nodule and inflammatoey pseudotumor of liver respectively.Results:1.MRI manifestations of some isolated necrotic nodule presented hypointesity in T1WI and isotensity in T2WI,each of three cases presented heterogeneous intensity,slight hyperintensity an no indensity in the focus after angiography,some poci(3/7)had an envelope with thin circular slight delayed intensity.2.MRI manifestation of inflammatory pseudotumor of liver were depicted as hypointensity or isointensity in T1WI and slight hypointensity(4/5)or slight hypointensity with mottling hyperintensity in T2WI,in portal vein and delayed–phrase of contrasted scan,the manifestation of enhancement were ① obviously enhanced in the margin and weak in the center(3/5),② obvious circular enhancement(2/5).Conclusion:the plain and dynamic scan with contrasted enhancement by MRI can better distingguish the isolated necrotic nodule from the inflammtory paeudotumor of liver than other imaging,especially it has the unique clinical value in the diagnosis of isolated necrotic nodule,and helpful to the subdequent treat.