肝十二指肠韧带神经源性肿瘤的MRI诊断

MRI Diagnosis of Neurogenic Tumour of Hepatoduodenal Ligament

目的:探讨原发于肝十二指肠韧带神经源性肿瘤的磁共振表现。方法:回顾性分析3例经手术、病理证实的肝十二指肠韧带神经源性肿瘤。结果:3例均为良性神经源性肿瘤,神经鞘瘤2例,神经纤维瘤1例。MRI表现为肝十二指肠韧带区,肝门部及其下方、胰颈部上方类圆形单发软组织信号肿块,T2WI呈欠均匀高及稍高信号,T1WI呈均匀或欠均匀稍低信号,增强扫描明显强化,病变内可见小片状无强化的坏死或囊变区,1例以周边强化为主。肿瘤边界清楚,紧邻或推压周围血管及胆管,未见包裹侵犯,未见胆道或胰管梗阻扩张。结论:MRI对诊断原发于肝十二指肠韧带神经源性肿瘤有良好的定位诊断价值,其多方位成像对鉴别该区域来源于胆道、肝脏、胰腺、十二指肠的其他病变有重要价值。

Objective：To study the MR imaging appearances of neurogenic turnout originating from hepatoduodenal ligament. Methods： 3 cases of neurogenic tumour originating from hepatoduodenal ligament proved by surgery and pathology were retrospectively analyzed. Results ： All 3 cases were benign neurogenie tumors including neurilemmoma in 2 cases and neurofibroma in 1 case. The MRI findings were solitary, round or oval mass, showing soft tissue signal intensities, which were hyperintense or slightly hyperintense on T2 WI and hypointense or slightly hypointense on T1 WI,marked enhancement was showed after contrast administration. No enhancement was assessed in the necrosis or cystic areas of the lesions and 1 case mainly showed peripheral rim like enhancement. The location of tumors were whithin hepatoduodenal ligament, porta hepatis or below the porto hepafis region,above the neck of pancreas;they were well-defined,closely adjacent to or pushing the biliary tract and surrounding blood vessels. Conclusion： MRI is a useful approach for the diagnosis and localization of neurogemc mmour originanng from hepatoduodenal ligament, multi-planar imaging is especially meaningful in the differential diagnosis with other iesions originating from biliary tract,liver, pancreas or duodenum.