肝内胆管错构瘤5例的磁共振成像诊断及鉴别诊断

Five cases MRI reports of the intrahepatic bile duct hamartoma and related paper review

目的探讨成人肝脏胆管错构瘤的影像学表现,以提高对本病的认识。方法回顾性分析5例经手术、病理证实的肝内胆管错构瘤的影像学表现。对所有患者均行磁共振成像(MRI)平扫、磁共振胰胆管造影(MRCP)、增强扫描,并穿刺活检病理证实。结果 T1WI病变呈低于肝实质的信号,呈多发,沿血管胆管树分布,T2WI病灶显示清楚,呈明显的高信号,在MRCP序列上,多数病变显示为高信号,与T2WI比较,显示的病变数量有所减少。MRCP显示肝内多发类囊状高信号病变,与可见的胆管树不相通。增强扫描示各期病灶无强化,在增强扫描60 s,3 min肝实质明显强化,小囊状信号未见明显强化,形成明显的对比。结论成人肝内胆管错构瘤在影像学上无特征性表现,类似于肝转移瘤、肝脓肿、肝海绵状血管瘤等常见的肝囊性占位病变。

Objective To investigate the imaging performance of the adult intrahepatic bile duct hamartoma, in order to improve the understanding of this disease. Methods Retrospective analysis of 5 cases confirmed by surgery and pathology of intrahepatic bile duct hamartoma imaging findings. All patients underwent magnetic resonance imag-ing（MRI） scanning, magnetic resonance cholangiopancreatography （MRCP）, enhanced scanning, 5 cases of this group were confirmed by the biopsy. Results The signal of T1WI lesion was lower than the liver parenchyma and the le-sions were multiple along the vascular biliary tree. T2WI lesion signal was clear and high. In the MRCP sequence, the majority of lesions showed high signal compared with T2WI, and the number of lesions decreased. The MRCP showed the multiple intrahepatic cystic high signal which was not connected with visible biliary tree. In the enhanced scan-ning of lesion, there were no enhancement of the lesion in every stage. However, the liver pavenchyma significantly enhanced in 60 s and 3 min after enhanced scanning, and the small cystic signals was not significantly enhanced. Conclusion Adult intrahepatic bile duct hamartoma has no characteristic radiographic manifestations, which is simi-lar to the common liver cystic lesions of the liver metastases, liver abscess, hepatic cavernous hemangioma and so on.