肝脏孤立性坏死结节的MRI表现  

Solitary necrotic nodule of the liver：MRI findings

作　　者：耿利[1] 林川[1] 黄彬[2] 徐爱民[2] 杨家和[1] 程红岩[2] 吴孟超[3] 

机构地区：[1]第二军医大学东方肝胆外科医院综合治疗科, 上海200438 [2]第二军医大学放射科, 上海200438 [3]第二军医大学办公室, 上海200438

出　　处：《中华放射学杂志》2008年第3期294-297,共4页Chinese Journal of Radiology

摘　　要：目的总结肝脏孤立性坏死结节（SNN）平扫和动态增强MRI特征性表现。方法回顾性分析经手术病理证实的15例SNN的MRI征象，对病灶数目、形状、大小、部位、边界、平扫和增强后信号及强化方式进行评价。结果病灶单发14例，另1例有2个病灶。平扫T1WI及T2WI各发现15和14个病灶，增强扫描发现16个病灶。14个病灶最大径≤3cm。平扫T1WI病灶呈低信号5个，略低信号9个，1个呈等信号伴有周边低信号包膜及内部点状低信号。在T2WI病灶呈高信号5个，略高信号4个，略低信号3个，明显低信号2个，其中2个病灶内见点状或细线样极高信号。16例在增强扫描后各期均呈低信号，尤其在门静脉期及延迟期呈明显低信号，边界及形态显示清楚。12个病灶形状不规则，4个病灶呈圆形或卵圆形。增强后病灶内部均未见强化，3个病灶在门静脉期及延迟期可见细环状轻度强化的包膜。结论SNN特征性MRI表现有助于与肝脏其他肿瘤鉴别。Objective To determine the characteristic features of solitary necrotic nodule （SNN） of the liver on precontrast and dynamic contrast enhanced magnetic resonance （MR） imaging. Methods We retrospectively reviewed 15 patients with histopathologically proved SNN. All of the images were evaluated for lesion features including the number, shape, size, location, border, signal intensity and pattern of enhancement. Results Sixteen lesions were found in 15 patients. Nonenhanced T1- and T2 weighted images depicted 15 lesions in 14 patients and 14 lesions in 13 patients respectively. Maximum diameter of 14 lesions was less than 3 cm. On unenhanced T1-weighted images, 5 lesions were hypointense, 9 lesions were slightly hypointense,and 1 was isointense with hypointense capsule and central punctate hypointense foci. Among 14 lesions demonstrated on T2-weighted images, 5 were hyperintense, 4 were slightly hyperintense, 3 were slightly hypointense, and 2 were hypointense. Punctate or linear high signal intensities were found in 2 lesions. All lesions were not enhanced after contrast injection. On portal venous and delayed phase, all lesions appeared significantly hypointense with well-defined border. The shape was irregular in 12 lesions and was round or oval in 4 lesions. No enhancement was found in the lesion except thin delayed enhancement in capsules of 3 lesions after contrast agent administration. Conclusion Characteristic MRI features of SNN are helpful for distinguishing SNN from other hepatic lesions.

关 键 词：肝肿瘤 磁共振成像 诊断显像 

分 类 号：R686[医药卫生—骨科学]