肝脏结节病变的影像诊断分析

Imaging Diagnosis of hepatic nodules

目的:探讨肝脏结节病变的影像诊断与鉴别诊断价值。方法:回顾性分析经临床证实的直径≤3 cm肝脏结节30例的临床资料。结果:本组采用Pick6000螺旋CT扫描15例,Philips Briliance 64层螺旋CT扫描8例,采用MR扫描8例(其中1例同时行MR及CT扫描)。诊断为肝硬化并小肝癌12例,血管瘤8例,肝硬化结节、转移瘤、坏死结节各3例,局灶性结节增生(FNH)1例。平扫大部分表现为低密度结节,增强扫描动脉期:小肝癌中8例明显强化,3例血管瘤整个病灶结节状强化,1例FNH明显强化;静脉期及延迟扫描:肝癌均为低密度;8例血管瘤均为等密度或稍高密度;肝硬化结节病变呈等密度;3例坏死结节中1例无明显强化,边缘较清晰,2例病灶轻度环形强化;3例转移瘤中1例为轻度环形强化,2例无明显强化,边缘模糊;FNH密度略低。结论:CT、MR平扫、多期增强扫描对肝脏结节病变的诊断与鉴别诊断价值较高。

Objective：To study the imaging features and differential diagnosis of hepatic nodules. Methods：Imaging findings of 30 patients confirmed by clinical manifestation with ≤3cm diameters were retrospectively analyzed. Results：15 Cases were scanned by Pick6000,8 by Philips Briliance and 8 by MR （ including 2 by both MR and CT scanning ）. There were 12 cases of liver cirrhosis merges the small liver cancer,3 cases of cirrhotic nodule,3 cases of metastases,8 cases of hemangioma, 1 case of focal nodular hyperplasia （ FNH）, 3 cases of inflammatory pseudotumor, most of which showed hypodensity on plain CT. On arterial phase ： there were obvious enhancement in 8 patients with cancer,very obvious enhancement in 1 patient with FNH and a whole nodule enhancement in 3 patients with hemangioma. Portal venous phase and delayed phase：there were hypodensity in all cancers,iso-density in 3 cirrhotic nodule,iso-density or slight hyperdensity in 8 hemangioma, slight hepodensity in 1 FNH;among the 3 metastases, one was of slight ring enhancement,the other two were of no obvious enhancement and vague border;among 3 necrotic nodule,one showed no obvious enhancement, the other two showed slight ring enhancement. Conclusion：Correct imaging diagnosis is possible in hepatic nodules by multi-phase helica CT and MRI scan,and it is of great value in differential diagnosis.