肝脓肿的MRI平扫及动态增强信号特征分析  

Analysis of MRI Characteritics in plain and Gd-DTDA dynamic enhanced sign in hepatic abscesses

作　　者：袁振国[1] 曲蕾[1] 张新娟[1] 姚建[1] 陈立光[1] 王光彬[1] 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2011年第11期1695-1698,共4页Journal of Medical Imaging

基　　金：山东省科技发展计划项目(编号:2008EG2004)

摘　　要：目的:探讨肝脓肿的MRI平扫及动态增强扫描信号特点。方法:对临床及手术病理证实的21例肝脓肿患者MRI平扫及增强后动态扫描资料进行回顾性分析。结果:21例中,单发肝脓肿13例,多发8例,共39个主病灶,15个伴多发子灶。39个主病灶中,"簇样征"3个,蜂窝网格状、花边样征24个,"环靶征"12个。平扫示主病灶T1WI间隔及壁呈等低信号、脓腔低信号,T2WI间隔及壁略高信号、内脓腔呈更高信号;子病灶中央见点状T1WI低、T2WI高信号;20个主病灶周围见片状或肝段性T2WI高信号。增强后动态扫描:①动脉期肝脓肿27个主病灶分隔及边缘轻度强化,12个主病灶壁轻度强化、其中10个壁边缘明显强化;②门脉期分隔或/和壁强化逐渐明显、壁边缘持续强化,边界更加清晰;③延迟期(1～5min)分隔或/和壁持续强化。30min延迟扫描8个主病灶,壁内层仍见强化,壁边缘强化减退;④子病灶环边缘动脉期轻度强化、门脉期及延迟期强化逐渐明显;⑤主、子病灶坏死脓腔均无强化;⑥28个主病灶周围见片状或肝段性动脉期一过性强化。结论:MRI平扫及动态增强扫描能较好的显示肝脓肿的发生、演变、发展及转归过程,反映肝脓肿的特征表现。Objective：We did a retrospective study to analyze MRI characteristic and its utility in the diagnosis of hepatic abscesses. Methods：We retrospectively reviewed and analyzed MRI findings of liver abscesses in 21 patients confirmed clinically and pathologically. Results：Thirteen patients had a single lesion and 8 patients had multiple lesions,with a total of 39 liver abscesses.Of all abscesses,fifteen lesions were associated with satellite nodules,3 with ＂cluster sign＂,24 with lace pattern and crest septum sign,and 12 with ＂target sign or ring sign＂.Plain scanning images showed that high signals in T2 weighted images and low signals in T1 weighted images in all 39 lesions and in the center of the satellite nodules.In addition,we also found high T2 weighted hepatic segmental or lamellar signals around 20 major lesions.The enhanced scanning images were as follows.First,27 lesions were demonstrated internal septa and margin enhancement in arterial phase and twelve lesions showed weak wall enhancement,of which 10 had apparent mural marginal ring enhancement.Second,internal specta and/or wall increased enhancement with mural margin continued enhancement,was found in portal phase.Third,in the delayed phase,internal specta and/or wall persisted with negligible change in the degree of enhancement was detected during 1～5 min.Mural inner part remained relatively hyperintense,whereas the mural marginal ring enhancement decreased or disappeared in 30 min at 8 lesions.Forth,mildly peripheral ring enhancement in arterial phase was found in satellite nodules and intensity of the enhancement increased gradually in portal and delayed phase.Fifth,the necrotic areas of all lesions and satellite nodules were showed no enhancment.Lastly,28 lesions were found to have hepatic segmental or lamellar enhancement in arterial phase,which faded to isointensity on intermediate phase images. Conclusion：MRI could be used as an important diagnostic modality for identifying the existence,monitoring the disease process,and reflecti

关 键 词：肝脏 脓肿 磁共振成像 

分 类 号：R575.4[医药卫生—消化系统] R445.2[医药卫生—内科学]