肝脏炎性假瘤的CT诊断与病理分析

CT Diagnosis and Pathologic Analysis of Hepatic Inflammatory Pseudotumor

目的:探讨肝脏炎性假瘤的CT表现与病理及病程的关系。方法:回顾性分析11例经病理证实的肝脏炎性假瘤患者的CT影像特征和病理表现,结合文献资料探讨病变影像、病理及病变进程之间的关系。结果:11例患者12个病灶,全部平扫表现为低密度,增强扫描4例在动脉期及门静脉期均无明显强化,有7例强化,其中2例病灶周围环状强化,病灶本身不强化,5例病灶周边不规则强化或内部间隔强化。本组CT检查有4例误诊。全部病变病检见肝脏正常组织结构破坏,代之以纤维母细胞,伴有慢性炎性细胞浸润。部分病灶中央呈片状凝固性坏死,周边组织充血水肿。结论:肝脏炎性假瘤多表现为包膜下方低密度病灶,部分病灶可强化;增强表现与不同的病理基础相关,并且反映了病变的进展过程。

Objective：To investigate the computed tomographic（CT） features of hepatic inflammatory pseudotumor and their correlation with pathologic findings and course of disease.Methods：CT features and pathologic findings of 11 cases of hepatic inflammatory pseudotumor confirmed pathologically were analyzed retrospectively.The correlation among the images of lesions,pathological changes,and progression of the disease was studied.Results：Twelve nodules appeared as hypointense lesions in all 11 cases at plain CT scan.At contrast-enhanced CT,the nodules were non-enhanced in arterial phase and venous phase in 4 cases,and the remaining were enhanced.Peripheral enhancement was found in 2 cases,and internal septa enhancement in 5 cases.Misdiagnosis was made in 4 cases at CT scan.On pathologic examination,the normal tissue of liver was destroyed and replaced by myofibroblasts with chronic inflammatory infiltration.Coagulative necrosis in central area and congestion in periphery were found in some cases.Conclusion：Hepatic inflammatory pseudotumors may display hypo-intensity nodules under the liver capsule,and some lesions were enhanced at CT scan.The enhanced CT features were correlated with pathologic findings and reflected the course of disease.