肝结核的影像学诊断  

Imaging Diagnosis of Hepatic Tuberculosis

作　　者：康素海[1] 谢伟[1] 张辉[2] 刘起旺[2] 张政[1] 

机构地区：[1]太原市解放军第264医院放射科,山西省太原市桥东正街太原030001 [2]山西医科大学第一附属医院影像科

出　　处：《中国医学计算机成像杂志》2013年第3期227-230,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨螺旋CT与MRI平扫及三期增强扫描联合应用对各型肝结核的诊断价值。方法:共11例患者:全部做螺旋CT、MRI平扫,10例做CT三期增强扫描,2例做MRI三期增强扫描,该组病例经穿刺活检证实。结果:①浆膜型:2例,分为结节性及囊性。囊性分为渗出型和纤维愈合型,前者囊壁无钙化,后者囊壁有钙化;前者邻近肝实质为稍低密度或稍长T2信号影,后者为等密度或正常肝实质信号。②肝实质型:9例。粟粒型,5例,肉芽肿小结节可分为三种类型,有干酪样坏死、无干酪样坏死及愈合钙化性小结节。表现为不同程度肝肿大,伴少量可被检出的融合性小结节。结节型,4例,可分为增生性和愈合性结节。结论:CT增强与MRI联合应用可为诊断各型肝结核提供更准确的诊断依据。Purpose： To discuss the value of three-phase enhanced spiral CT and MR scanning in the diagnosis of hepatic tuberculosis. Methods： Eleven cases with hepatic tuberculosis underwent plain CT and MR scanning, 10 of them underwent three-phase enhanced spiral CT scanning, 2 of them underwent three-phase enhanced MR scanning. All the cases were proved by biopsy. Results： （1） Serohepatic type （n=2, four lesions）. The lesions were nodular or cystic. The cystic lesions were divided into two subtypes, one was exudation subtype, and the other was fibrous subtype. The former had no calcification at the cyst wall, and was with slight inflammation in the adjacent liver parenchyma, which was slight hyperintense on T2-weighted imaging. The latter had calcification at cyst wall, and was with no inflammation of adjacent parenchyma. （2） Parenchymal type（n= 9）;① Miliary type （n=5）. There were three kinds of granuloma, with or without caseous necrosis and with calcified nodule. Hepatomegaly with few nodules was shown on CT and MRI. ② Nodular type （n=4）. There were two kinds of types, hyperplastic and healing nodular. Con- clusion： It can offer more accurate evidences for diagnosis of hepatic tuberculosis by using three-phase enhanced spiral CT and MRI scanning.

关 键 词：肝结核 动态增强 体层摄影术 X线计算机 磁共振成像 

分 类 号：R525[医药卫生—内科学]