肝脏孤立性坏死结节的CT及MRI表现

CT and MRI Findings of Solitary Necrotic Nodule of Liver

目的:探讨肝脏孤立性坏死结节(SNN)的螺旋CT及高场强MRI表现,提高对SNN的诊断准确性。方法:回顾性分析30例(34个)经手术病理证实的SNN患者的影像学表现。其中10例行螺旋CT平扫和3期动态增强检查,20例行MRI平扫及增强检查。结果:CT发现11个病灶,MRI发现23个病灶。CT平扫示病灶均呈低或稍低密度,6例中央可见星芒状更低密度区,增强扫描动脉期病灶均无明显强化,延迟期4个病灶有边缘强化。MRT1WI示23个病灶均为低或稍低信号,10个病灶中心见点状、星状更低信号;T2WI示5个病灶呈稍低信号、18个为稍高信号;增强扫描动脉期所有病灶均未见明显强化,8个病灶门脉期及延迟期边缘强化。16个病灶中心更低密度/信号区均未见强化。结论:CT平扫和动态增强及MRI能较好地反映SNN的影像学特点,提高了对SNN的诊断准确性。.

Objective： To evaluate the CT and MRI findings of solitary necrotic nodule （SNN） of liver,in order to improve the accuracy of diagnosis. Methods：The imaging findings of 30 patients with 34 SNNs proved by surgery and pathology were analyzed retrospectively. Spiral CT was performed in 10 patients,MRI was performed in 20 patients. Results： 11 SNNs were detected by CT, whereas 23 SNNs were detected by MRI. Hypo- or slightly hypo-attenuated lesions were showed on pre-contrast CT, central star-shape more hypo-attenuated area was showed in 6 lesions. No obvious enhancement was assessed on post-contrast CT images,4 lesions had peripheral enhancement on delayed phase. Of the 23 lesions detected by MRI, hypo- /slightly hypo-intense lesions were assessed on TI WI, central dotted or stellate more hypo-intense area was assessed in 10 lesions. On T2WI, 5 slightly hypo-intense lesions and 18 hyper-intense lesions were seen. No obvious en- hancement was revealed in arterial phase after contrast administration, peripheral enhancement could be assessed in 8 lesions on portal vein phase and delayed phase. No enhancement was assessed in the hypo-attenuated /hypo-intense region within the lesion center. Conclusion：The imaging characteristics of SNN could be assessed on pre- and post-contrast dynamic en- hanced CT and MRI,which is helpful to improve the accuracy of diagnosis.