肝脏炎性假瘤的动态增强CT及MR扫描(附17例分析)

Dynamic CT and MR scanning of inflammatory pseudotumor of the liver(analysis of 17 cases)

目的:探讨肝脏炎性假瘤的CT、MR表现特点及其诊断价值。材料与方法:回顾性分析17例肝脏炎性假瘤的临床资料及CT、MR动态增强扫描表现,对其影像表现和病理学检查结果进行对照。结果:17例患者共发现20个病灶。CT动态增强扫描显示肝脏炎性假瘤的强化方式多样,其中动脉期呈轻微强化(4例)或无强化(7例);门脉期及延迟扫描常有一定程度强化,常见强化形式为边缘环状强化(7例)或中心点状强化(3例)或偏心状强化(1例)。MR平扫T1WI显示病灶为低信号、略低信号或等信号,T2WI为等信号或高信号。团注Gd-DTPA后,病灶的强化形式与CT动态增强表现相似。结论:肝脏炎性假瘤的强化方式反映了其病理学特征,CT、MR动态增强扫描对其鉴别诊断有重要的价值。

Objective: To investigate CT and MR characteristics and value of inflammatory pseudotumor of the liver(IPL). Materials and Methods: CT and MRI features of IPL and clinical materials of 17 patients were reviewed. All the lesions were proved by aspiration needle biopsy specimens guided by CT and ultrasound, or surgery. CT and MR dynamic scans were analyzed for appearance of the masses and ancillary findings in correlation with histopathologic findings. Results: There were 20 lesions detected in 17 cases. On dynamic CT scanning, IPL demonstrated as slight enhancement(4 cases) and non-enhancement (7 cases) in arterial phase. In porto-venous phase and delayed phase, the lesions often demonstrated ring-enhancement(7 cases) and centric enhancement(3 cases) and eccentric enhancement(1 case). On MR T1WI lesions were hypointense, slightly hypointense or isointense relative to the liver, and on T2WI they were isointense or hyperintense. After bolus injection of Gd-DTPA, enhancement pattern of IPL was similar to that of dynamic enhanced CT. Conclusion: Dynamic enhanced CT and MR images of IPL can reflect its histopathologic characteristics, and has of differential diagnostic value.