白血病合并肝脏真菌感染的MRI表现

MRI findings of fungal liver infection in patients with leukemia

目的 分析白血病合并肝脏真菌感染患者的MRI表现,探讨其诊断价值。方法 选取18例白血病合并肝脏真菌感染患者的临床与影像学资料,所有患者均行MRI平扫及增强检查,分析其MRI表现。结果 MRI扫描表现为肝实质内多发结节状及斑片状异常信号。肝内病灶MRI表现分为3型:Ⅰ型,环征,MRI表现为类圆形异常信号灶,病变中心增强扫描未见强化,而病变外周部增强扫描呈环状强化;Ⅱ型,靶征,病变中央可见不规则小结节影,小结节外周可见环状或不规则状T1WI低信号T2WI稍高信号,增强扫描病灶中央小结节可见强化,其周围异常信号在动脉期未见强化,门静脉期可见强化,病变最外缘可见强化;Ⅲ型,单纯低信号影,MRI表现为小结节异常信号,病变信号均匀,边缘清楚,增强扫描病变边缘轻度强化,而中心低信号未见强化。结论 白血病合并肝脏真菌感染的MRI表现有一定影像学特点,结合免疫功能缺陷病史有助于早期诊断。

Objective To analyze MRI findings of liver fungal infection in patients with leukemia,and to explore its diagnostic value.Methods Clinical and MRI data of 18 patients with leukemia accompanying with fungal liver infection were collected retrospectively.All patients underwent non-enhanced and enhanced MRI scanning andthe characteristics of MRI findings were analyzed.Results Based on MRI findings,three different types of lesions were found.Type Ⅰ,ring sign,was lack of enhancement in the center of the lesion,while,rim ring-like-enhancement was found.Type Ⅱ,target sign,the irregular nodules can be seen in the center of the lesion,the nodules were surrounded by abnormal signal,which were shown ring or irregular low signal on T 1WI and slightly high signal on T 2WI;enhancement can be seen in the central nodules of the lesion;no enhancement can be seen around the central nodules in arterial phase,and enhancement was found in portal vein phase;enhancement can be found at the outer edge of the lesion.Type Ⅲ was simple low signal foci.MRI showed abnormal signal of nodules.The signal of lesion was uniform and the edge was clear.Slightly enhancement can be observed at the outer edge of the lesion,but not in the central low signal region.Conclusion Liver fungal infection in patients with leukemia shows certain characteristics on MRI imaging.Combining MRI findings with the history of immune deficiency contributes to early diagnosis of liver fungal infection.