异位肝组织的影像学诊断

Imaging diagnosis of ectopic liver tissues

目的总结异位肝组织的影像学特征,分析影像学技术对异位肝组织影像的诊断价值。方法收集42例经组织病理学确诊为异位肝组织患者的临床资料,包括CT平扫、动态增强CT、MRI平扫以及动态增强MRI等影像学检查的结果,分析其影像学特征。结果42例患者异位肝组织均为单发病灶,多发生于胆囊。MRI平扫:34例患者T1加权像(T1WI)序列为不均匀低或稍低信号,T2WI、T2压脂序列为不均匀高或稍高信号;8例患者T1WI序列提示为等信号,T2压脂、T2WI序列提示为高信号。动态增强MRI示异位肝组织与正常肝组织强化同步且强化幅度较正常肝组织更高。CT平扫示病灶密度均匀,其中8例内部可见囊变或钙化。动态增强CT示CT强化与正常肝组织同步,但增强后异位肝组织强化更为明显。27例患者主要供血动脉为左或右肝动脉延续,6例源于肝固有动脉,6例源于肠系膜上动脉,3例经CT最大密度投影重建提示血供为肝S2门静脉分支。结论异位肝组织影像学表现具有相应特征性,影像学检查在疾病诊断中具有一定应用价值。

Objective To summarize the radiological characteristics of the ectopic liver tissues and analyze the diagnostic value of imaging techniques on it.Methods Clinical data of 42 patients with ectopic livers diagnosed by histopathology were collected,which included the imaging findings of CT,dynamic enhanced CT,magnetic resonance imaging(MRI)plain scan and dynamic enhanced MRI.Results Forty-two patients with ectopic liver lesions were all single lesion,most of all occurred in the gallbladder.In 34 patients,the MRI T1WI sequences showed uneven low or slightly low signals,and the T2WI and T2 fat suppression sequences showed uneven high or slightly high signals.In 8 patients,the T1WI sequences showed equal signal,and the T2 fat suppression and T2WI sequences showed high signal.Dynamic contrast-enhanced MRI showed synchronous enhancement of ectopic liver and normal liver tissues,and the enhancement amplitude was higher than that of normal liver tissues.CT scan showed uniform density,and 8 cases showed cystic change or calcification.CT enhancement was synchronized with normal liver tissues,but the ectopic liver tissues enhancement was more obvious after enhancement.The main supplying artery of 27 patients came from the left or right hepatic artery continuation,that of 6 cases originated from the proper hepatic artery,6 cases originated from the superior mesenteric artery,and 3 cases were with hepatic S2 portal vein branch reconstructed by CT maximum intensity projection.Conclusion The imaging manifestations of the ectopic liver tissues have corresponding characteristics,and imaging examinations have a certain application value in the diagnosis of the ectopic liver tissues.