肝脏炎性假瘤的增强CT、MRI表现特点与病理对照研究

Manifestation Characteristics of Contrast-enhanced CT and MRI of Hepatic Inflammatory Pseudotumor in Comparison with Pathology

目的分析肝脏炎性假瘤的增强计算机X线断层扫描(CT)、磁共振(MRI)表现特点及其与病理表现的关系。方法收集我院经病理学检查证实的78例肝脏炎性假瘤患者临床资料,记录CT、MRI及二者联合对肝脏炎性假瘤的诊断准确率、CT及MRI增强扫描表现特点;根据肝脏炎性假瘤的病理表现分为中心坏死型、成片坏死型、纤维组织增多型、多组织混杂型,比较不同病理表现病灶的CT及MRI增强扫描表现特点。结果CT、MRI及二者联合对肝脏炎性假瘤的诊断准确率分别为82.05%、83.33%、83.33%,不同检查方式诊断准确率无显著差异(P>0.05)。根据CT、MRI增强扫描表现,可将其归为四周环形强化、无明显强化、环状+分隔状强化、不均匀持续强化共4种类型。不同病理表现病灶的CT及MRI增强扫描特点具有显著差异(P<0.05),其中中心坏死型以四周环形强化居多(85.71%),成片坏死型以无明显强化居多(83.33%),纤维组织增多型以环状+分隔状强化居多(86.67%),多组织混杂型以不均匀持续强化居多(91.67%)。结论肝脏炎性假瘤不同病理表现的CT及MRI增强扫描表现特点不同,应结合其他临床资料综合判断。

Objective To analyze the manifestation characteristics of contrast-enhanced computed tomography(CT)and magnetic resonance imaging(MRI)of hepatic inflammatory pseudotumor and their relationship with pathological manifestations.Methods The clinical data of 78 patients with hepatic inflammatory pseudotumor confirmed by pathological examination in the hospital were collected,and the diagnostic accuracy rates of CT,MRI and their combination for hepatic inflammatory pseudotumor and the manifestation characteristics of CT and MRI contrast-enhanced scans were recorded.According to the pathological manifestations of hepatic inflammatory pseudotumor,the lesions were classified into central necrosis type,patchy necrosis type,increased fibrous tissue type and multi-tissue mixed type.The manifestation characteristics of contrast-enhanced CT and MRI scans were compared among lesions of different pathological manifestations.Results The diagnostic accuracy rates of CT,MRI and their combination for hepatic inflammatory pseudotumor were 82.05%,83.33%,and 83.33%respectively,but there was no significant difference in the diagnostic accuracy rate of different examination methods(P>0.05).According to the manifestations of contrast-enhanced CT and MRI scans,the lesions could be assigned to four types of circumferential annular enhancement,no obvious enhancement,annular+septal enhancement and heterogeneous continuous enhancement.There were significant differences in characteristics of contrast-enhanced CT and MRI scans among lesions of different pathological manifestations(P<0.05).The central necrosis type was mostly with circumferential annular enhancement(85.71%),the patchy necrosis was mostly without obvious enhancement(83.33%),the increased fibrous tissue type was mostly with annular+septal enhancement(86.67%),and the multi-tissue mixed type was mostly with heterogeneous continuous enhancement(91.67%).Conclusion Different pathological manifestations of hepatic inflammatory pseudotumor have different characteristics of contrast-enhanced CT and MRI scans,which should be comprehensively judged in combination with other clinical data.