肝脏多房环形强化病变的影像分析

Analysis of Imaging Findings of Hepatic Multi-locular Ring-enhancement Lesions

目的:分析肝脏多房环形强化的影像学特征,探讨肝脓肿、肝内胆管细胞癌、肝转移瘤的鉴别诊断要点。方法:回顾性分析31例肝脏病变表现为多房环形强化的影像学特征,其中肝脓肿15例,肝内胆管细胞癌7例,肝转移瘤9例。13例行上腹部CT平扫和三期增强检查,7例行MRI平扫及LAVA多期增强检查,11例同时行CT和MRI检查。结果:3种病变在环壁及分隔的强化征象有差异。肝脓肿环壁及分隔均匀、完整(P<0.05),可见病灶缩小征(P<0.05)。胆管细胞癌环形强化呈向心性充填(P<0.05),或出现肝包膜回缩(P<0.05)和扩张胆管壁的局限性增厚。环壁不规则中断或见强化的壁结节,是诊断转移瘤较有价值的征象。结论:肝脓肿、肝内胆管细胞癌、肝转移瘤3种病变各有其影像特点,CT及MR检查对三者的诊断与鉴别诊断有重要价值。

Objective： To study manifestations of hepatic multilocular and ring-enhancement lesions and differential diagnosis of liver abscess, intrahepatic cholangiocarcinoma and liver metastasis. Methods： Imaging＆nbsp;findings of 31 cases were retrospectively analyzed, including liver abscess 15cases, intrahepatic cholangiocarcinoma 7 cases and liver metastasis 9 cases. 13 cases carry the CT plain scan and three phases enhanced examination of upper abdominal. 7 cases underwent MRI plain scan and LAVA multiphase scanning. 11 patients underwent CT and MRI examination meanwhile. Results： There was a statistical difference among the three multilocular and ring-enhancement lesions for the enhancement signs of the morphology of ring wall and septum. The ring-wall and septum thickness uniformity, complete enhancement （P 〈 0.05）, and the appears mass diminution sign （P 〈 0.05）.The ring enhancement in a centripetal filling （P 〈 0.05） or retraction of liver capsule （P 〈 0.05） and expansion of bile duct wall local thickening, the findings is helpful to diagnosis cholangiocarcinoma. The ring-wall irregular interrupt or enhancing wall nodule, it has great value for diagnosis for liver metastasis. Conclusions： The three lesions have their imaging features, combine with CT and MRI have a high value for differentia diagnosis of the three lesions.