肝脏炎性假瘤的CT表现与病理学对照观察

Inflammatory pseudotumor of the liver:CT manifestation and pathologic findings

目的探讨肝脏炎性假瘤(IPL)的CT表现特点。方法回顾性分析10例经病理证实的肝脏炎性假瘤病例的CT平扫及动态增强扫描表现,并与病理结果对照分析。结果10例肝脏炎性假瘤呈单发孤立肿块,CT平扫9例表现为低密度,1例表现为稍高密度。动态增强扫描2例动、门脉期及延迟期均无强化;3例动、门脉期及延迟期病灶呈分隔状强化;4例动、门脉期及延迟期病灶呈环形强化;1例动脉期和门脉期无强化,延迟期呈中心结节状强化。病理主要表现为大片凝固坏死及周边纤维组织包绕和较多炎性细胞浸润。结论CT动态增强扫描可充分反映病灶的血供特点和病理特征,在肝脏炎性假瘤的诊断和鉴别诊断中具有很大价值。

Objective To investigate CT manifestation of inflammatory pseudotumor of the liver（IPL）.Methods Ten cases with pathologically-proven IPL underwent plain and dynamic enhanced CT scan,then findings were analyzed comparatively with pathological examination.Results Single isolate mass was found in all 10 patients,low-density in 9 cases and slightly high-density in 1 case on CT plain scan.Enhancement was not seen in 2 cases.During arterial phase,portal ve-nous phase and delayed phase,septal enhancement and ring-shaped enhancement was found in 3 and 4 cases,respectively.IPL in 1 case did not enhanced during arterial phase and portal ve-nous phase,but central nodular enhancement was noticed during delayed phase.Pathological examination showed large areas of solidified necrosis surrounded by large amount of fibrous tissue and inflammatory cells infiltration in the lesions.Conclusion Dynamic enhanced CT scan can reflect the blood supply and pathological characteristics of IPL sufficiently,and is of great value in the diagnosis and differential diagnosis of IPL.