肝脏炎性假瘤的CT和MRI诊断

CT and MRI Diagnosis of Inflammatory Pseudotumor of the Liver

目的：探讨对肝脏炎性假瘤的ＣＴ和ＭＲＩ表现。材料与方法：２５例经手术和病理证实的肝脏炎性假瘤。男１５例，女１０例，年龄３１～５６岁，平均３９岁。２５例均作ＣＴ平扫及增强检查，其中１０例为常规方法，１５例为螺旋ＣＴ多期扫描，后者中７例行ＭＲ对比。结果：ＣＴ表现为病灶形态多样化，单病灶１７例，双病灶６例，３病灶２例。螺旋ＣＴ增强动脉期病灶内均无早期强化，静脉期和延迟期２５例病灶周边有环状强化，１２例伴有中央核心强化，３例病灶内缘有钟乳石样强化，２１例病灶内有粗细不均的纤维分隔形成。ＭＲＩ表现为ＳＥ序列Ｔ１加权低信号，Ｔ２加权等信号。快速动态增强扫描表现与螺旋ＣＴ相仿。结论：ＣＴ和ＭＲ。

Objective: To investigate CT and MR appearance of inflammatory pseudotumor of the liver.Materials and Methods:Twentyfive patients (15 male, 10 female) aged 31 to 56 years (mean 39 years) with pathologically proven inflammatory pseudotumor of the liver were included. All of the patients underwent CT scanning, scans were performed by conventional CT in 10 patients and by helical CT in the remaining 15 cases. MR images were obtained for comparison in 7 of the 15 patients who were examined by helical CT.Results:On CT scans, the foci presented various appearance. 17 patients had a single hepatic mass, 6 patients had 2 masses and the other 2 had three foci. No early enhancement was detected by arterial phase scanning of helical CT. Ringshaped enhancement at the periphery of masses were observed in all 25 patients on portovenous phase and delayed scans. 12 cases were accompanied by central zone enhancement. 3 cases had stalactitical enhancement in marginal zone of foci fibrous septa with various thickness in foci were observed in 21 patients. MR showed low signal intensity on T1WI and isosignal intensity on T2WI. Signal presentation of fast dynamic enhanced images were similar to that of helical CT.Conclusion: CT and MR, especially multiplephase helical CT scanning and dynamic MR images, are of some value in differential diagnosis.