肝结核的CT与MRI表现

CT and MRI manifestations of hepatic tuberculosis

目的 探讨肝结核的CT、MRI表现及其诊断价值。方法 回顾性分析经病理证实的12例肝结核的CT和MRI表现。结果 (1) 12例CT表现 :肝浆膜型 1例 ,为肝包膜下多发结节性病灶。肝实质型 10例 ,其中多发粟粒小结节状低密度灶伴点状钙化 2例 ,单发略低密度大结节伴斑点状钙化及聚集多个结节样病灶形成“成簇征”或融合成蜂窝状改变各 3例 ,多发囊样病变及多发粟粒状钙化伴单发大结节低密度灶各 1例。肝内胆管型 1例 ,肝内胆管明显扩张及肝门部多发斑点状钙化灶。 (2 ) 4例MRI表现 :T1WI、T2 WI低信号灶 1例 ,T1WI低信号、T2 WI高信号灶 3例 ,增强后为轻度边缘强化或呈多环状强化。结论 各种类型肝结核均有其特定的影像学表现 ,典型的CT、MRI表现可提示该病的诊断。

Objective To assess CT, MR manifestations and diagnostic value in hepatic tuberculosis. Methods CT findings in 12 cases and MR findings in 4 cases with hepatic tuberculosis proved by surgery or biopsy were retrospectively analyzed. Results (1) CT findings: one case of serohepatic type of hepatic tuberculosis was multiple nodular lesions in the subcapsule of liver. Parenchymal type were in 10 cases, including multiple,miliary, micronodular and low density lesions with miliary calcifications in 2 cases, singular, low density mass with multiple flecked calcifications in 3 cases, multiple cystic lesions in 1 case, multiple micronodular and low density lesions fusing into multiloculated cystic mass or “cluster” sign in 3 cases, and singular, macronodular and low density lesion with multiple miliary calcifications in 1 case. One case of tuberculous cholangitis showed marked dilated intrahepatic duct with multiple flecked calcifications in the porta hepatis. (2) MR findings in 4 cases were hypointense on both T 1WI and T 2WI in one case, hypointense on T 1WI and hyperintense on T 2WI in 3 cases. Enhanced MR in 3 cases showed slightly peripheral enhancement or with multilocular enhancement. Conclusions Various types of hepatic tuberculosis had their different imaging findings. The typical CT and MR findings could suggest the diagnosis.