50例肝脏炎性假瘤的临床分析

INFLAMMATORY PSEUDOTUMOR OF THE LIVER:ANALYSIS OF 50 CASES

目的 探讨肝脏炎性假瘤的临床表现 ,为诊断及治疗提供依据。方法 收集 5 0例经手术和病理证实的肝脏炎性假瘤病例资料进行回顾分析。结果 该组平均年龄 4 4岁 ,男性多见 ,占 6 8%。 5 0例患者中 2 5例无明显症状 ,2 1例有右上腹疼痛 ,4例出现发热。病灶位于右叶占 80 %。其中 84 %患者 B超表现为低回声或略低回声 ,6 6 %边界清楚 ,72 %肿块内部回声不均匀。CT检查示均为低密度影 ,形态不规则 ,只有 19.4 %的患者增强扫描后出现不同时期的增强。 17例患者行 MRI检查 T1加权为低信号 ,不均匀 ,边缘模糊 ,质子加权为等信号 ;T2加权 4例等低信号 ,2例等信号 ,11例为略高信号 ,病灶内似有分隔 ,增强后只有 2例轻度强化。 5 0例术后均恢复良好。结论 B超发现肝脏炎性假瘤的重要手段 ,动态 CT扫描及 MRI对于鉴别其它肝脏占位有较大帮助。

Objective To investigate the features of hepatic imflammatory pseudotumor(IPT),and promote the diagnosis and treatment of hepatic IPT.Methods Data from fifty cases with hepatic inflammatory pseudotumor(IPT) confirmed by operation and pathology were studied retrospectively.Results The average age of the them was 44.About 68%(34/50) of patients were male.In the 50 patients,25 hadn't significant symptoms,21 suffered right upper abdominal pain and 4 had the fever.The lesions of 80% were located in the right lobe.Ultrasonic examination showed that the lesions in 84% patients were hypoechoic,66% with clear edge,and 72% with inhomogeneous echo.Hypodense and irregular shape mass can be seen in the patients CT scan,and only 19.4% of IPT had slight enhancement in the contrast CT scan.The MRI examination from 17 cases revealed that T1WI of the lesions was hypointense with unclear margin,T2WI was isointense,slightly hypointense or subtly hyperintense.Septa can be seen in some lesions.Conclusion Ultrasonography is an important method in finding the lesion.Dynamic CT scan or MRI is of great value in differential diagnosis of other liver mass.Resection is the preferential treatment.