肝脏嗜酸性粒细胞浸润的多层螺旋CT表现  

The appearances of eosinophilic hepatic infiltration on multi-slice spiral CT

作　　者：张忠林[1] 梁长虹[1] 李景雷[1] 刘再毅[1] 刘于宝[1] 余元新[1] 谢淑飞[1] 王秋实[1] 

机构地区：[1]广东省人民医院广东省医学科学院放射科,广州510080

出　　处：《中华放射学杂志》2009年第8期840-843,共4页Chinese Journal of Radiology

基　　金：广东省科技计划项目（200717031515008）

摘　　要：目的探讨肝脏嗜酸性粒细胞浸润的多层螺旋CT表现。方法回顾性分析经病理证实的10例肝脏嗜酸性粒细胞性浸润的CT影像资料。观察病灶数目、部位、形态、边缘、大小、密度、强化程度以及病灶与门静脉的关系。结果单发病灶2例，多发病灶5例，弥漫性病变3例。病灶主要分布于肝包膜下或门静脉周围肝实质内。肝包膜下多为楔形，肝实质内多为不规则形；大病灶多为楔形或不规则形，小病灶多为圆形。病灶直径4～48mm，平扫病灶呈稍低或等密度，边界模糊；动脉期轻度强化或无强化；门静脉期显示最清，数目最多，边界较清晰，呈相对低密度，8例均匀强化，2例部分病灶中心片状不规则强化；平衡期呈等密度8例，2例弥漫性者少部分病灶为稍低密度。10例病灶内均见门静脉分支穿行，无门静脉充盈缺损或闭塞，无占位征象；3例门静脉分支周围见伴行条状低密度带。结论肝脏嗜酸性粒细胞浸润多层螺旋CT影像表现有一定特征，三期动态增强CT扫描对其诊断具有较高价值。Objective To study the imaging findings of eosinophilie hepatic infiltration on multislice spiral CT. Methods A retrospective analysis was performed to assess the muhi-sliee spiral CT imaging findings of 10 eases of pathologically confirmed eosinophilie hepatic infiltration. Evaluations were made regarding the lesions＇ number, site, shape, margin, size, density, enhancement pattern and the relationship between lesions and portal veins. Results CT demonstrated a single lesion in 2 eases, multiple lesions in 5 and diffuse infiltrative lesions in 3. All lesions were located in subeapsular parenehyma or surrounding the portal vein. Most subeapsular lesions were wedge-shaped, and lesions in the deep parenehyma were irregular. Larger lesions were wedge-shaped or irregular while smaller ones were round or oval. Their size ranged from 4 to 48 ram. On pre-eontrast images, these lesions showed slightly low density or isodensity with fuzzy edge. During the arterial phase of post-contrast CT, these lesions exhibited slight enhancement or no enhancement. All lesions were notable and showed relatively low density with homogeneous enhancement and well-defined margin, while centrally heterogeneous enhancement was found in 2 eases during portal venous phase. Isodensity was found in 8 eases during delayed phase, and slightly low density for minor lesions in 2 eases with diffuse lesions. Branches of portal vein was found infiltrated by all lesions, without filling defect or obstruction; low-attenuated stripes surrounding branches of portal vein were found in 3 eases. Conclusion The multi-slice spiral CT findings of eosinophilie hepatic infiltration are relatively specific, and three-phase dynamic CT studies can be a valuable tool for the diagnosis of this disease.

关 键 词：肝疾病 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]