原发于肝十二指肠韧带病变的MRI诊断

MRI Diagnosis of Primary Mass in Hepatoduodenal Ligament

目的探讨肝十二指肠韧带(HDL)的正常解剖及原发于HDL病变的磁共振(MRI)表现,评价原发于HDL病变MRI的诊断.方法回顾分析2004年8月至2013年10月昆明医科大学第二附属医院经药物(抗结核)或手术治疗、病理证实的肝十二指肠韧带原发病变11例,均行MRI平扫、增强检查.结果 11例均为良性病变,其中淋巴结结核3例,神经鞘瘤2例,神经纤维瘤1例,畸胎瘤1例,淋巴管瘤2例,单纯囊肿2例.其中1例予抗结核治疗9个月后复查病变减少.另10例手术均完整切除,随访3月至5 a未见复发.结论 MRI对诊断原发于肝十二指肠韧带病变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提供影像学依据.MRI良好的软组织分辨率有助于病变定性诊断及鉴别诊断.

Objective To explore the MRI imaging appearance of the normal anatomy and primary mass in hepatoduodenal ligament and to evaluate the diagnostic value of its abnormalities by MRI. Methods From August 2004 to October 2013, ll cases of lesions in hepatoduodenal ligament confirmed by drug therapy （antituberculosis therapy） or surgery and pathology were collected. All were performed plain and enhanced MRI. Results Eleven cases were benign lesions including lymph nodes tuberculosis in 3 cases, neurilemmoma in 2 cases, neurofibroma in 1 case, teratoma in 1 case, lymphangioma in 2 case and simple cyst in 2 cases. There was no relapse after 3 months - 5 years. Conclusion MRI has a good diagnostic value in locating the lesions in hepatoduodenal ligament and its multi-aspect image formation is very useful in differentiating other tumor developing from biliary tract, liver, pancreas or duodenum. Its good soft tissue resolving power is helpful for qualitative diagnosis and differential diagnosis.