CT和MRI对肝右叶发育不良的诊断价值探讨

Application of computed tomography and magnetic resonance in diagnosis of agenesis of right hepatic lobe

目的探讨电子计算机断层扫描（CT）和磁共振成像（MRI）对肝右叶发育不良的诊断价值。方法选取24例在本院行CT和MRI扫描的肝右叶发育不良患者，结合文献资料综合分析患者肝脏CT和MRI影像学检查特点。结果本组肝右叶发育不良患者24例，男性8例，女性16例；年龄在40-85岁，平均年龄为（60．7±3.2）岁：采用MRI检查发现者6例，采用CT检查发现者18例，两种检查方法诊断者4例；影像学检查表现为肝右叶体积缩小，门静脉及其分支出现细小或者缺如。肝左叶增大18例，肝左叶正常6例。尾状叶体积缩小，伴有尾叶内发生胆汁淤积3例，尾状叶体积增大者15例。14例出现肝外胆管结石，12例胆囊右后旋，8例患者行胆囊切除。24例患者均出现了肝内胆管扩张，12例出现脾脏增大，9例伴发肝脏肿瘤，并发腹膜转移1例。结论CT和MRI检查对于诊断肝右叶发育不良具有重要的临床意义。

Objective To investigate the application of computed tomography （CT） and magnetic resonance imaging （MRI） in diagnosis of agenesis of fight hepatic lobe. Method Twenty-four patients with agenesis of right hepatic lobe were recruited in our hospital,and they were all checked-up by CT and MRI. Results Our series included eight men,and sixteen women,with the average age of （60.7±3.2） yr-old;the agenesis of right hepatic lobe were diagnosed by MR1 in 6,by CT in 18,and by both in 4;the imaging showed shrunk volume of right lobe,narrow portal vein and even lost its branches;left hepatic lobe enlarged in 18,and with normal left hepatic lobe in 6;hepatic caudate lobe shrank in 3,and enlarged in 15;extrahepatic bile duct stone in 14, dislocation of gall bladder in 12;all patients had cholangiectasis,12 had splenomegaly,and 9 had neoplasm. Conclusion The application of CT and MR imaging for the diagnosis of right lobe dysplasia have important clinical significance.