放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2015年
8期
845-848
,共4页
邵丹丹%王雪雪%赵骞%贾宁阳%陈克敏%程红岩
邵丹丹%王雪雪%趙鶱%賈寧暘%陳剋敏%程紅巖
소단단%왕설설%조건%가저양%진극민%정홍암
肝脏%孤立性坏死结节%磁共振成像%体层摄影术,X线计算机%病理学
肝髒%孤立性壞死結節%磁共振成像%體層攝影術,X線計算機%病理學
간장%고립성배사결절%자공진성상%체층섭영술,X선계산궤%병이학
Liver%Solitary necrotic nodule%Magnetic resonance imaging%Tomography,X-ray computed%Pathology
目的：探讨肝脏孤立性坏死结节（SNN）的 MRI、CT表现及其鉴别诊断价值。方法：回顾性分析经手术病理证实的47例SNN的临床及影像学资料。38例行腹部 MRI 平扫及增强检查，7例行腹部CT 平扫及增强检查，2例同时行MRI和CT检查。结果：病灶位于肝右叶39例（39／47，83．0％），肝左叶8例（8／47，17．0％）；分布于肝实质边缘42例（42／47，89．4％），肝脏深部5例（5／47，10．6％）；病灶最大径≤2．5 cm者25例（25／47，53．2％）、＞2．5 cm者22例（22／47，46．8％）；形态不规则29例（29／47，61．7％），呈圆形或椭圆形18例（18／47，38．3％）。MRI 示所有病灶于T1 WI 上呈低信号－等信号，32例病灶T2 WI上呈等信号－稍高信号、8例呈稍低信号。CT平扫示所有病灶内部呈稍低－低密度影，1例病灶边缘可见环形钙化。三期增强扫描显示所有病灶内部无强化，周边有薄环状延迟强化，其中18例病灶内间隔有轻度强化。结论：SNN的 MRI、CT表现具有一定特征性，有助于该病的诊断。
目的：探討肝髒孤立性壞死結節（SNN）的 MRI、CT錶現及其鑒彆診斷價值。方法：迴顧性分析經手術病理證實的47例SNN的臨床及影像學資料。38例行腹部 MRI 平掃及增彊檢查，7例行腹部CT 平掃及增彊檢查，2例同時行MRI和CT檢查。結果：病竈位于肝右葉39例（39／47，83．0％），肝左葉8例（8／47，17．0％）；分佈于肝實質邊緣42例（42／47，89．4％），肝髒深部5例（5／47，10．6％）；病竈最大徑≤2．5 cm者25例（25／47，53．2％）、＞2．5 cm者22例（22／47，46．8％）；形態不規則29例（29／47，61．7％），呈圓形或橢圓形18例（18／47，38．3％）。MRI 示所有病竈于T1 WI 上呈低信號－等信號，32例病竈T2 WI上呈等信號－稍高信號、8例呈稍低信號。CT平掃示所有病竈內部呈稍低－低密度影，1例病竈邊緣可見環形鈣化。三期增彊掃描顯示所有病竈內部無彊化，週邊有薄環狀延遲彊化，其中18例病竈內間隔有輕度彊化。結論：SNN的 MRI、CT錶現具有一定特徵性，有助于該病的診斷。
목적：탐토간장고립성배사결절（SNN）적 MRI、CT표현급기감별진단개치。방법：회고성분석경수술병리증실적47례SNN적림상급영상학자료。38례행복부 MRI 평소급증강검사，7례행복부CT 평소급증강검사，2례동시행MRI화CT검사。결과：병조위우간우협39례（39／47，83．0％），간좌협8례（8／47，17．0％）；분포우간실질변연42례（42／47，89．4％），간장심부5례（5／47，10．6％）；병조최대경≤2．5 cm자25례（25／47，53．2％）、＞2．5 cm자22례（22／47，46．8％）；형태불규칙29례（29／47，61．7％），정원형혹타원형18례（18／47，38．3％）。MRI 시소유병조우T1 WI 상정저신호－등신호，32례병조T2 WI상정등신호－초고신호、8례정초저신호。CT평소시소유병조내부정초저－저밀도영，1례병조변연가견배형개화。삼기증강소묘현시소유병조내부무강화，주변유박배상연지강화，기중18례병조내간격유경도강화。결론：SNN적 MRI、CT표현구유일정특정성，유조우해병적진단。
Objective:To explore the MR and CT appearances and imaging differential diagnosis of solitary necrotic nodule (SNN)of the liver.Methods:The clinical and imaging features of 47 patients (29 men and 18 women;age range,32~71 years;median age,49 years)with pathologically confirmed SNN were retrospectively reviewed.All the cases underwent plain and dynamic contrast-enhanced MRI and/or CT scan of the abdomen (38 cases with MRI scan,7 cases with CT scan, and 2 cases with both MRI and CT scan).Results:Thirty-nine lesions (39/47,83.0%)were located in the right lobe of the liver,and 8 (8/47,17.0%)in the left lobe.Forty-two lesions (42/47,89.4%)were found in the sub-capsular region,mean-while 5 lesions (5/47,10.6%)were located within the deep hepatic parenchyma.The maximum diameter of 25 masses (25/47,53.2%)were less than or equal to 2.5cm,and 22 masses (22/47,46.8%)were larger than 2.5cm.Twenty-nine masses (29/47,61.7%)were irregular,meanwhile 18 cases (18/47,38.3%)were round or oval.SNN presented hypo-intense or iso-intense on T1 WI in all cases.Thirty-two lesions were hyper-intense or iso-intense on T2 WI,and 8 lesions were hypo-in-tense on T2 WI.On the plain CT,all cases showed slightly low to low density within the lesions,of which only one case showed the annular calcification.After contrast administration,the central part of the lesions showed no enhancement,and the peripheral part showed thin ring-like delayed enhancement in all cases.In addition,18 lesions showed slightly delayed enhancement of the septa within the lesions.Conclusion:The MRI and CT appearances of solitary necrotic nodules of the liver are characteristic and helpful in the diagnosis of the diseases.
